You'll find KI-3 at the depression between the inner side of the ankle and the tendon, just behind the anklebone. The treatment strategy was modified. She walked as much as she could, turning about every 30 steps, walking with confidence and a smile on her face. She responded immediately after the needles were inserted, her voice sounding much clearer and stronger. Although there is no cure for stroke, most stroke patients now have a good chance for survival and recovery. The man had developed paralysis in the right arm and hand after an operation on the left side of his brain to remove a tumor. Julia, a 49-year-old female in a wheelchair, was brought to our clinic in Santa Fe, NM, in 1992. He did not like to perform speech, swallowing, and body exercises. Multiple sclerosis (MS) is a progressive disease of the central nervous system in which communication between the brain and other parts of the body is disrupted. Muscle strength is often rated at six levels on a scale of 0 out of 5 to 5 out of 5.6,a The level of 0 out of 5 shows no muscular contraction, which means complete paralysis; the level of 1 out of 5 shows some muscular contraction, but no limb or body movement; the level of 2 out of 5 shows limb movement is possible but not against gravity, which means the limb can only move in its horizontal plane; the level of 3 out of 5 shows limb movement is possible against gravity but not against resistance by the examiner; the level of 4 out of 5 shows limb movement is possible against some resistance by the examiner but it is still weak compared to a normal limb; and the level of 5 out of 5 shows normal muscular strength, which means complete recovery from paralysis. Although multiple sclerosis (MS) remains an incurable disease of the central nervous system, scalp acupuncture provides an important complementary/alternative treatment approach for improving many symptoms and the patient's quality of life by slowing or reversing the progression of physical disability and reducing the number of relapses. Use the fewest number of needles possible in the scalp and rotate them at least 200 times per minute with the thumb and index finger for one minute, twirling as gently as possible so that the child patient can tolerate the sensation and repeating the stimulation every 10 minutes. Various famous physicians introduced Western neurophysiology into the field of acupuncture and explored correlations between the brain and human body. An official website of the United States government. This case study followed the patient as his post-stroke swallowing status changed and various acupuncture decisions were made. A hospital physician recommended that Fred try acupuncture treatment. a Editor's note: The references in this article have been renumbered for continuity. Common points are Si Bai (St 2) threaded toward Di Cang (St 4), Di Cang (St 4) threaded toward Jia Che (St 6), Yu Yao (extra point) threaded toward Tai Yang (extra point), Yang Bai (GB 14) threaded toward Yu Yao (extra point), and Xia Guan (St 7), He Gu (LI 4), and Tai Chong (Liv 3). In very serious cases, patients may need feeding tubes. Poliomyelitis, also called polio or infantile paralysis, is a highly infectious viral disease that may attack the central nervous system and is characterized by symptoms that range from a mild nonparalytic infection to total paralysis. To relax contractures of the foot and ankle, thread a two-inch needle from Jie Xi (St 41) toward Qiu Xu (GB 40) and Sheng Mai (Bl 62). Since scalp acupuncture is a modern technique with just 39 years of history, much more research needs to be done so that its potential can be fully explored and utilized and more paralyzed patients helped to regain a normal life. First, up to now there has been no authoritative and practical text for scalp acupuncture in English. This book contains many amazing case reports from our years of clinical practice and teaching as examples of what is possible using these techniques. Many of these same patterns will be present in cases involving post-stroke symptomology discussed in this book such as paralysis, dysphagia, and aphasia. Scalp acupuncture is the best therapy for spinal cord injury. This book will show the scope of scalp acupuncture in treating many kinds of disorders and diseases, based on years of clinical experience. Though shocked and stunned watching her walk up to greet him, her doctor was thrilled with her progress and hoped for more excellent results. From their teachers and textbooks, students can learn only general information about scalp acupuncture and its locations and clinical applications. Its effects can range from relatively benign in most cases, to somewhat disabling, to devastating for some people. Throughout its long history, acupuncture has evolved as its own unique traditional medicine. Babies can be born with facial palsy and they exhibit many of the same symptoms as adults with Bell's palsy. Tell the child that those are normal and are a good sign for improving more quickly. The role of acupuncture is to unblock the channels. Although scalp acupuncture areas may be chosen according to the patient's particular symptoms, primary areas for patients with motor problems such as paralysis, weakness of limbs, or abnormal sensations in limbs including tingling, numbness, or pain, are the Motor Area and the Sensory and Foot Motor Areas. Facial paralysis, according to Chinese medicine, involves both disregulation of qi and blood causing mal-nourishment of the channels in the facial region, as well as invasion by pathogenic wind-cold or phlegm. Unlike traditional acupuncture, where one needle is inserted into a single point, in scalp acupuncture needles are subcutaneously inserted into whole sections of various zones. The incontinence of urine also showed some improvement. Julia was also in much better control of urination, now holding her urine for six hours at night. Having proven effective through clinical results recorded over the last 35 years, it can effectively stimulate the paralyzed area in order to restore the body's energy flow to a normal state so that the body can heal itself. Forty-five successful case histories are given from our clinical experience. Keep the needles in for 2530 minutes. Her aphasia gradually improved and she was able to drag her right leg while walking and move her right arm slightly but the paralysis had shown no further improvement for the past eight weeks. At the time, scalp acupuncture was primarily used to treat paralysis and aphasia due to stroke. Communicate with children and their parents more often than with adult patients in order to reduce their fear and anxiety. Dr. Halpern: There are a few differences between MR-guided focused ultrasound and deep brain stimulation. Her left ovary hurt and the pain was worse during menses. For the last three years and currently, she could not stand or walk by herself due to weakness in her legs and loss of balance. The https:// ensures that you are connecting to the Compared to other patients, in general depressed patients should receive fewer needles, milder stimulation, and a shorter time of needle retention. During treatment, some patients may have all or some of the following sensations: heat, cold, tingling, numbness, heaviness, distention, or the sensation of water or electricity moving in the affected side of the face. Five years ago she had a dramatic neurological decline during which she was unable to stand up and lost strength and sensation in her lower extremities. Examination showed he was unable to move his right leg and foot at all with muscular tone at 0 out of 5. Scalp areas are frequently used in pain management, especially pain caused by the central nervous system such as phantom pain, reflex regional pain, and residual limb pain. Exercise is very important for the recovery of affected limbs. Most existing textbooks either lack detailed information or only introduce some new research on the topic. In terms of Western medicine, it contributes significantly to the treatment of central nervous system disorders. Indication: tinnitus, vertigo, diminished hearing, Menier's syndrome. 5.3, 5.23 and 5.24). Third, manual manipulation is very difficult to learn and master without detailed description and demonstration. The scalp's unique neurological and endocrinal composition makes it an ideal external stimulating field for internal activities of the brain. Former heaven or prenatal natural endowment insufficiency may also play a role. It is also a good strategy to ask the parents to talk, play with, or feed young patients during the insertion and stimulation of needles, which acts as a diversion to turn the child's attention away from the needles and makes them less sensitive to the procedure. The outcome measures included the patient's (1) subjective evaluation of her percentage of improvement before and after weekly treat Retain the needles in place for 1020 minutes. She could pick up pennies on a table with either hand during the treatment. Examination showed that the sensations in his right arm and hand were still normal. "Essential tremor: choosing the right management plan for your patient." Cleveland Clinic Journal of Medicine, December 2011; 78(12):821-8. The relapse rate of the scalp acupuncture group was 13.81% She called the Western medicine physician who had told her she would be paralyzed for the rest of her life and gave him the wonderful news. Her walking was much more stable and she was able to lift both legs much higher. After treatment on the Motor Area of the scalp, 7,637 cases were cured (36.5%), 7,117 cases showed marked improvement (34%), and 5,196 cases showed some improvement (24.8%), yielding a total effective rate of 95.13%. During the third treatment she was able to stand on her feet with someone holding her knees and could lift her arms much higher. After only one treatment per patient, three of the seven veterans instantly felt no further phantom pain, three others reported having very little pain, and only one patient showed no improvement. He systematically undertook the scientific exploration and charting of scalp correspondences starting in 1971. Though the scalp is uniquely innervated and highly vascularized there is no risk of heavy bleeding. Maximum phonation duration of seven seconds indicated reduced breath support, likely resulting from vocal cord paralysis. For treating motor dysfunction, place the needles and rotate them at least 200 revolutions per minute for 13 minutes every 10 minutes for a total of 3060 minutes. However, to treat dysphagia patients who have depression is very challenging because patients are not always willing to participate in the treatment. In the West, many healthcare practitioners are familiar with acupuncture for pain management, while scalp acupuncture as a main tool for rehabilitation is a relatively new concept. Although more yang ming points are used for paralysis, points from yin channels, especially tai yin and jue yin channels should not be ignored. Examination showed she was unable to stand and walk straight by herself. Therefore it is imperative to deal with the dangers of dysphagia through dietary management once acupuncture has been instituted. Medicines can help some people, while others may need surgery. It is necessary for stroke patients to receive emergency treatment with Western medicine and it is important to identify a stroke as early as possible because patients who are treated earlier are more likely to survive and become less disabled. Compared to adult patients, generally speaking, young patients should receive fewer needles, milder stimulation, and shorter time of needle retention. Readers may notice that the indications for treatment for each scalp area are many in order to demonstrate the variety of disorders that can benefit from scalp acupuncture therapy. Her neck was severely damaged at the level of C-5 and C-6. She had been receiving rehabilitation treatment including physical therapy, osteopathic therapy, and speech therapy starting two weeks after her injury. For patients such as Sherry who present with multiple symptoms and signs, it is, in our experience, more effective to treat major complaints first with a few needles. In treating unilateral paralysis of the limbs, traditionally more points from yang ming channels are selected because yang corresponds to movement and agility, and foot yang ming stomach channel controls muscle functions. With much excitement and audience applause, she followed our instruction and started to move: one step, then two, three, and four steps. However, a number of therapies including acupuncture can be used to treat the disease symptomatically and convert MS into remission. Although the most obvious symptom is impairment to the limbs, function is also impaired in the torso. Just like any new technology and science, the discovery, development, and clinical application of scalp acupuncture has undergone a period of challenge because it falls outside some fundamental theories of Chinese medicine as well as being a new concept in the Western world. If treating a patient with Bell's palsy within seven days of its onset, it is wise to inform patients that their condition is not yet stable and more or worse symptoms can continue to develop. Scalp acupuncture is a modern acupuncture technique combining traditional needling method with western medicine knowledge of representative areas of the cerebral cortex. As well, he could not close his left eye, raise his left eyebrow, show his upper teeth, frown, or puff out his left cheek. Stimulate all needles with vigorous thrusting, lifting, and twirling. His wife gave a brief medical history because of his aphasia. Treatment is given two to three times per week and a therapeutic course consists of 10 treatments. There are many different acupuncture techniques for treating MS. Vertigo and hearing area (ni) Location: Horizontal line 1.5 cm above and centered on the apex of ear, 4 cm in length. The patterns presenting in these diseases usually include a complex combination of liver blood, kidney yin, and spleen qi deficiencies along with damp heat further consuming the blood and damaging the qi, and thus depriving the limbs of strength and the flesh and muscles of nourishment. Jia Huai-yu reported on 1,800 cases of paralysis due to stroke treated on the Motor Area by scalp acupuncture in 1992. Paralyzed muscles may be flaccid, flabby, and without appreciable tone, or may be spastic, tight, and with abnormally high tone that increases when the muscle is moved. Progressive muscular atrophies are a wide group of genetic disorders characterized by primary degeneration of the anterior horn cells of the spinal cord, resulting in progressive muscle weakness. He had suffered from multiple sclerosis since 1982 and had received many kinds of treatments with no positive results. It is not advisable to use electrical stimulation on the needles in the face because it may cause facial muscle spasm. We need to emphasize that this patient received only three scalp acupuncture treatments and had recovered completely. Initially, treatment should be two to three times a week until major improvements are achieved, then once weekly, then every two weeks, and then spaced out as indicated by the patient's condition. At that time her leg and arm muscles were so much stronger that she was able to write and make phone calls. She had less mucous in her nose and throat and no nausea since the last visit. The pulse reading showed lack of force in the inch (cun) and bar (guan) positions, with faint pulses in the cubit (chi) position. She had little hope that our treatment would help her condition. Though she continued to improve with each treatment, the most dramatic changes occurred in the twentieth treatment. Insert needles in the Motor Area, Sensory Area, and Foot Motor and Sensory Area and stimulate unilaterally or bilaterally according to the patient's symptoms. Liu Jian-hao and colleagues reported on the treatment of 60 cases of paralysis due to stroke using scalp acupuncture in 2010. During the third treatment the next day, the patient reported that she walked better with more control of her left leg and that it felt less heavy. Rotate the needles at least 200 times per minute with the thumb and index finger for 13 minutes, twirling them as vigorously as the patient can tolerate and having the patient move her affected limbs actively and passively. Scalp acupuncture can be an excellent rehabilitation tool for traumatic brain injury patients. During the first treatment, Julia experienced immediate relief from the muscle spasms. Since the patient's attitude was relatively more positive toward acupuncture therapy, we were able to perform stronger stimulation after inserting needles at the same locations as for the initial treatment. The signs and symptoms of dysphagia include difficulty controlling food in the mouth, inability to control food or saliva in the mouth, difficulty initiating a swallow, coughing, choking, frequent pneumonia, unexplained weight loss, gurgly or wet voice after swallowing, nasal regurgitation, and swallowing difficulty. Modern medicine has not yet found a cure for spinal cord injury. 8600 Rockville Pike She watched and listened to herself on the video screen while she walked and talked like a normal person. His fatigue was so great he could only walk 23 minutes at a time. 3.3 Chorea-Tremor Control Area (CTCA) Location: Parallel to and 1.5 cm anterior to Motor Area (see Figs. Clinical studies have demonstrated that acupuncture may be beneficial for PD . Also hernias or bulges of intervertebral discs may cause spinal cord compression. In A Practical Dictionary of Chinese Medicine, Wiseman and Feng translate this pulse image as the string-like pulse, but wiry is the more common usage. The treatment is given two to three times per week and a therapeutic course consists of 10 treatments. This is followed by the destruction of myelin. Although scalp acupuncture has the best and fastest response, other techniques are necessary for a fuller recovery. With children, select the thinnest needles that you can insert into the scalp. HHS Vulnerability Disclosure, Help Common acupuncture points include He Gu (LI 4), Qu Chi (LI 11), Jian Yu (LI 15), and Wai Guan (TB 5) for upper limb paralysis and Yang Ling Quan (GB 34), Feng Shi (GB 31), Huan Tiao (GB 30) Zu San Li (St 36), and Kun Lun (Bl 60) for lower limb paralysis. Primary lateral sclerosis is a rare motor neuron disease that resembles ALS but there is no evidence of the degeneration of spinal motor neurons or muscle wasting that occurs in ALS. Always put one needle in the ear point Shen Men to help nervous patients relax and reduce the sensitivity of needle insertion and stimulation of the scalp. However, those who don't have such sensations could still experience immediate and positive effects. From a Western perspective, these zones correspond to the cortical areas of the cerebrum and cerebellum responsible for central nervous system functions such as motor activity, sensory input, vision, speech, hearing, and balance. Currently, multiple sclerosis does not have a cure in terms of conventional treatments. At a workshop conducted at Tri-State Acupuncture College in New York City in 1998, a patient named Tom volunteered for scalp acupuncture. The patient thrived on this program. Sometimes those points were stimulated with electrical acupuncture. Communicate with the patient and any relatives often in order to gain their confidence, to encourage them, and reduce their fear and anxiety. In Sherry's case, the hemiplegia was caused by a motor neuron disorder. Tremor areas are classified as secondary areas . Because these were patients in a hospital, the treatment protocol was 6 days per week for about 30 days, with a follow-up check after 3 months. Her mental activity presented as normal and she was then in graduate school for a master's degree. Dr. Jiao combined a modern understanding of neuroanatomy and neurophysiology with traditional techniques of Chinese acupuncture to develop a radical new tool for affecting the functions of the central nervous system. After trying many kinds of therapies that brought no improvement, she became depressed. Our studies showed that 87% of patients had instant improvement after only one treatment. Her tongue showed a red tip, only a thin, white coating, and a peeling coating at the front. After the sixteenth treatment he had gained more mobility and use of his right hand and gained more muscular strength in that hand. In many cases, a flexible spending account may be used to cover acupuncture treatments. There are several different acupuncture techniques to treat paralysis. Most paralyses caused by nervous system damage are constant in nature. He could neither utilize a normal gait from heel to toe nor walk backwards. Disability affects about 75% of stroke survivors and it can affect patients physically, mentally, emotionally, or a combination of all three. His voice was low and it was very difficult to understand him. The duration of the condition was from 30360 days. In addition to the paralysis on the right side, his tongue was purple with teeth marks and a thin, white coating. I am so overjoyed with these unexpected wonderful results. Her primary doctor recommended that she try acupuncture treatment. The best results are usually achieved by applying low frequency (for example, 3 hertz) with high intensity (for instance, when visible muscle contraction is observed). Regular exercise helps the blood circulation and keeps muscles active, and this also accelerates the results from ongoing acupuncture treatments. At this point his weight increased and his stamina was markedly improved. Fred, a 62-year-old male in a wheelchair, was brought to our clinic in Santa Fe, NM. Commonly used points are Chi Ze (Lu 5) and Nei Guan (Per 6) for upper limbs and San Yin Jiao (Sp 6), Yin Ling Quan (Sp 9), Xue Hai (Sp 10), and Qu Quan (Liv 8) for lower limbs. The manager at the college told us that the patient had had a stroke from cerebral thrombosis only 11 months before and was a good candidate for the class demonstration. Retain the needles for 3045 minutes and treat two or three times a week. TCM body style acupuncture has been shown to benefit Parkinson's disease patients. Upon examination, it was found that she had paralysis of all four extremities. The next chapter is a review of essential theories of Chinese medicine related to scalp acupuncture including the Four Seas theory and the Four Qi Street theory that provide readers with a systematic explanation of function and indication based on Chinese medicine. The entire Motor Area should be needled and stimulated on the opposite side of the paralyzed limbs. 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