Interviews with the Masters; Professor Sanghoon Lee of Acupuncture & Moxibustion, Kyung Hee University, College of Korean Medicine
Vice Director, East-West Medical Research Institute, WHO Collaborating Center for Traditional Medicine
Director, International Education Institute of Korean Medicine
Kyung Hee University, Seoul, Korea
1. What is the treatment for facial palsy? (What is facial palsy?)
- Definition
Facial palsy can be distinguished in central and peripheral lesions. Most reported cases are peripheral facial nerve palsy caused by a problem with the facial nerve, or the seventh cranial nerve. Facial nerve palsy is one of the most common disease among cranial nerve diseases, which tends to cause the eyes and lips to droop to one side. Symptoms include pain or herpes simplex around the ear, or no other signs at all, before the facial muscles are paralyzed.
The 1st week of occurrence is seen as the acute phase, which the symptoms may worsen even under treatment. If the symptoms worsen after 3 to 4 weeks of treatment, a thorough checkup for finding other possible causes apart from peripheral facial nerve palsy is highly recommended.
- Symptoms
Facial palsy may, but rarely, occur on both sides of the face, but usually affect one side with muscle paralysis. From the forehead to the neck, the parts of the faces, including the eyebrow, eye, nose, and lips, are slanted to one side. The asymmetrical facial features affect not only the appearance, but other activities such as eating as well. Other symptoms include dry eyes or excessive tearing, pain around the ears, poor taste, and over-sensitive hearing.
- Complications
Poor prognosis of facial palsy is expected in the following cases: total paralysis (House-Brackmann Grade 6); when there is no recovery within three weeks despite the involvement of treatment; elderly patients; severe pain (usually ear pain); Ramsay-Hunt syndrome that shows herpes simplex virus around the ear; poor blood sugar control due to diabetes; EMG damage rate higher than 90 percent; taste dysfunction or salivary gland dysfunction; Non-involvement of active treatment in the early stages of the symptoms, etc.
Aftereffects are caused from incomplete recovery of facial nerves and abnormal regeneration. Some examples include remaining facial paralysis even after six months since the occurrence of the disorder, constriction in which the facial muscles on the paralyzed side are pulled and atrophied, convulsions in the eyelids or lips, synkinesis in which the movement of eye and mouth affect each other, and crocodile tears syndrome that causes tears when eating. To prevent aftereffects, it is critical that active and proper treatments are involved from the early stages of the disorder.
- Medication
Modern medicine administers high-dose steroids to reduce inflammation at the onset of the disease. Later, taking a rest while waiting for recovery is the general treatment procedure.
- Surgery
Facial nerve decompression surgery may be an option if there is complete damage shown on the electromyography at the disease onset and no treatment response is shown even after one month of treatment. However, this method accompanies side effects such as surgical complications, including incomplete recovery, permanent hearing loss, and inflammation, which is why it is not frequently considered by patients.
Facial palsy is usually treated completely if proper treatment is administered during the acute phase, which are days or weeks after the disease onset, to prevent worsening of the disease and stimulate recovery. Therefore, worrying excessively and feeling depressed are not helpful for the recovery. However, in the case where it is accompanied by diabetes and herpes zoster or over 90 percent of the nerves are damaged, partial paralysis and synkinesis may remain even after six months of treatment. This is why proper treatment from professional institutions is critical from the early stages of the disease. Most importantly, wrong home remedies, such as putting buttercups or other poisonous herbs on the wrist or face must be avoided.
<Diet>
There are no specifically good or bad food for facial palsy. The condition although may cause food left inside the mouth or leak of liquid food due to facial paralysis, so food that is difficult to chew or digest is discouraged. Facial palsy patients with diabetes must be careful with their blood sugar and diet when they are administered steroids that can cause sudden raise in blood sugar.
<Eye Treatment>
Facial palsy can cause dry eyes or cornea damage as the eyes may not properly shut. Eyedrops must be used regularly as well as eye ointment at night to prevent dry eyes for long hours.
<Facial Exercise>
Facial palsy patients cannot easily recognize how their faces are moving. Patients are encouraged to look at mirrors and check and practice facial movements. They should not put too much effort in trying to make faces, but fingers may be used to assist in moving muscles and making facial expressions.
4. Considering the treatment for facial palsy, what are the
benefits of Korean Medicine?
In modern medicine, there is nothing that can be done, but waiting, after high dose of steroids is administered for about ten days. Korean Medicine, on the other hand, inserts needles of general acupuncture, medicinal acupuncture, electric acupuncture, and intradermal acupuncture in the facial area, arms and legs, and increases immunity through moxibustion therapy in the lower abdominal area. In addition, our hospital prescribes newly developed Herbal medicine, namely Cheongan-tang and Cheongansohapwon, to remove inflammation and enhance immunity. We also educate patients physical therapy for effective rehabilitation of facial muscles and diaphragmatic breathing for a peaceful state of mind, which are expected to accelerate complete recovery.
5. What were the reactions of overseas experts when you
introduced this technique to them?
And what are your plans for overseas promotion of the
treatment for facial palsy?
Facial palsy has been a popular topic that has been lectured by experts of the US, UK, China, Hong Kong, Japan, Taiwan, and more. Foreign experts are surprised with Korean Medicine’s various acupuncture methods and other treatment techniques, such as thread-embedding (maeseon), moxibustion, Herbal medicine, electric acupuncture, dermal acupuncture, and taping therapy. In comparison, doctors of modern medicine rely on steroids and acupuncturists insert needles only in the peripheral areas of where the symptoms are visible. We will continue to promote our techniques overseas by developing acupuncture and moxibustion treatment, new facial exercise devices, and Herbal medicine.
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