Stroke or brain attack is one of the leading causes of mortality and morbidity in the United States today. It is the third leading cause of death, and the leading cause of long-term disability.
The Patient
The patient is a 64-year old white female with a two-year history of type 2 diabetes and a 15-year history of hypertension who suffered a stroke (a month prior to acupuncture treatment), which resulted in left facial paralysis and generalized weakness on the left side of her body.
Chief complaints: Facial paralysis, blurred and double vision, speech difficulties including slurring and difficulty pronouncing certain words, difficulty swallowing and chewing foods due to loss of tongue control. Other complaints included dizziness, generalized fatigue, poor balance and drooping of the left side of her face and eyelid.
Physical Assessment
Height: 5 ft. 4 inches
Weight: 273 lbs.
Blood pressure: 130/80
Radial pulse: 72
Respirations: 16
Vital signs remained within normal ranges throughout the patient's visits.
Tongue: Deep red color, swollen and deviating to the right. There was no tongue coating, and the gag reflex was absent.
Pulse: The overall character of the pulses on the right and left radial artery were rapid and thready, signifying kidney yin and yang deficiency.
Chinese Medicine Diagnosis
The diagnosis was wind stroke (zhong feng) attacking the channels and collaterals caused by increased liver yang and kidney yin and yang deficiency.
The patient received a total of eight (8) acupuncture treatments over a six-week period and experienced tremendous improvement in her condition. After the first treatment, her speech had improved noticeably and she no longer had difficulty with certain words. After the second treatment, her gag reflex returned and the facial drooping was approximately 95 percent improved. After the third week of treatment, her double-vision cleared, she no longer had to "use her finger to remove food from her cheeks," her swallowing returned to normal, and her hand grasp was equal bilaterally; however, she still continued to experience occasional dizziness. She was then given a vestibular exercise program for overcoming dizziness, including eye exercises, and vocalization exercises to further improve speech.
At the termination of treatment, the patient had no evidence of facial paralysis, speech distortion, swallowing difficulties or double vision. Normal facial symmetry was restored. The acupuncture treatment included the use of auricular acupuncture with body point combination; classical and empirical points that treat muscular atrophy. The following points were selected and used during the course of treatment.
Ear points: Liver, parathyroid, occiput, trigeminal nucleus, parathyroid control, minor occipital nerve, cerebellum, cheeks, and point zero.
Body points: Du 20; ST 4, 6, 8, 31, 32, 36, 40, 41; LV 3; Sp 6; CV23; LI 4, 11, 15, 14; ba xie, tai yang, yin tang, yu ye, she jian, and jin ying.
Herbal Formula
Herbal formulas are an important supplement to any acupuncture regimen, and the following herbal formula (tian ma gou teng yin) was prescribed. The following ingredients are listed and may be modified depending on other clinical findings. This formula is useful in extinguishing liver wind. It calms or sedates the spirit and promotes blood circulation. It resolves problems such as blurred vision, tinnitus, headache, irritability, insomnia, numbness, and tremors of the hands and feet. No known contraindications exist; however, if a patient shows signs of allergic response, discontinue immediately. This formula was used successfully with this patient.
Tian Ma Gou Teng Yin (Gastrodia & Uncaria Formula)
- tian ma (gastrodia), 9 grams
- gong teng (uncaria), 12 grams
- shi jue ming (abalone), 18 grams
- zhi zi (gardenia fruit), 9 grams
- huang qin (scute ), 9 grams
- niou xi (cyathula root), 12 grams
- du zhong (eucommia bark), 9 grams
- yi mu cao (motherwort), 9 grams
- sang ji sheng (loranthus), 9 grams
- ye jiao teng (fleeceflower stem), 9 grams
- fu shen (poria/holen), 9 grams
The combination of ear acupuncture points (auriculotherapy) and body points along with Chinese herbs offer the best results when stroke patients are treated immediately after the onset of symptoms. Acupuncture, along with physical therapy and other Western modalities, offers patients the best hope for recovery.