Clinical Case StudiesReal Patients, Real Medicine

Joey Chan BHkin Dip AOMj RAc
February 2013

Acupuncture Case StudyA 50-year-old female with Bell’s palsy presents with hemi-facial paralysis involving the eye and the mouth. After 5 weeks, 10 acupuncture treatments and 2 months of Chinese herbal medicine, she experienced a 90% recovery.


Patient is a 50-year-old female presenting with right side paralysis of the face involving the forehead, eyes and mouth. The paralysis developed suddenly, 1 week prior to her first consultation at the clinic. Patient recalls having a low fever and chills for 3 days, with a slight sore throat and cough. On the 4th day, she woke with hemi-facial paralysis marked by an inability to close her right eye, with additional tearing and swelling of the right eye. She reports she has not slept at all for 7 days because her affected eye will not close. Patient describes symptoms of forehead pain and tightness, which can lead to twitching of the eye during severe pain. She also reports eye twitching when she is in a cold environment.

She experiences constant vertex and occipital headache, described as deep and moving pain, in addition to sharp pain behind the right ear. The left side of her mouth is being pulled and is tight, while the right side of the mouth is painful. She describes her face as being numb and drying up. She also feels chills and dizziness, usually in the morning and evening. She states that her overall body temperature alternates between hot and cold, though her hands and feet always feel cold. She reports her energy is very low, her body feels heavy, and she has no appetite. She is losing her sense of taste. She states that there has been no improvements since the incident and she has not seen any other health care providers.


Patient appears to be weak and has low energy. She is thin with her cheekbones protruding. She talks in a quiet and slow voice. She looks tired and her eyes are always looking down. The right side of her face is expressionless and the left side is tight. The patient’s right eyelid droops down covering ¼ of her eye. The patient’s right eyebrow and
eye is asymmetrical to the left, with the right side sitting ¼ inch lower than the left side. 

Facial expression tests of the seventh cranial nerve consist of blinking the eyes, closing the eyes, wrinkling the forehead, smiling and frowning. When tested, patient is unable to close her left eye or blink. She can only close the eye ¼ of the way. The patient’s right forehead does not wrinkle when compared to the left side. The patient refuses
to smile and frown when asked. Sharp/dull sensory test shows lack of differentiation on the right side of the face. Motor facial tests of saying the sound “E” and “O” show asymmetry of the mouth. Saying “A” is symmetrical.

Patient’s demeanour appears low and her eyes dull. Her face color is dark and dull and her nails are pale. Her tongue is dry with a red heart tip, white coat and a quiver. Her pulse is deep and weak and very faint on the right.


DX: Asymmetrical facial expressions of the right side of the forehead, eyebrows, eye and mouth and the loss of taste shows that the seventh cranial nerve is affected, leading to the diagnosis of Bell’s palsy. Damage to the orbicular oculi is shown from the lack of passive eyelid movement. Occipitalis and frontalis muscles responsible for lifting
the eyebrows and wrinkling the forehead are also affected. Mentalis, risorius, levator labii superioris and depressor labii inferioris damage is seen from the asymmetrical facial expressions of saying E, O and smiling.

Damage of the seventh cranial nerve affects the taste sensory of the anterior 2/3 of the tongue.

TCM DX: External wind-cold attack of the Bladder Taiyang channel leading to blockage in the Bladder Taiyang and Stomach Yangming channels, with underlying qi and blood deficiency and dampness from Spleen qi deficiency.

The patient’s symptoms began with a wind-cold attack, presenting with fever and chills, slight sore throat and cough. The wind-cold entered the Bladder and Stomach channels of the face, leading to wind invasion and blockage of these channels. Wind-cold symptoms shown are vertex and occipital headache around BL10, pain at SJ17 on
the right side, twitching of the eye that is worse in a cold environment, and a quivering tongue. Blockage along the Stomach and Bladder channels on the face is shown by hemi-facial paralysis and lack of sensation on the face.

Qi and blood deficiency signs and symptoms are fatigue, poor appetite, dull eyes, dull and dark facial complexion, pale nails, numbness of the face, dry tongue and a deep weak and faint pulse.

Dampness signs are shown on the tongue with a white coating, as well as a heavy feeling in the body.

PROGNOSIS: Patient seeks treatment at this clinic 1 week after onset of initial symptoms. Improvement is more likely due to early diagnosis and treatment. Significant improvement may be possible with a course of 10 acupuncture treatments and 2 months of Chinese herbal medicine.


Treatment principle: First expel wind-cold and then tonify Spleen qi and blood and resolve damp.

Treatment: Acupuncture 2-3 times per week for 10 treatments before re-evaluating; Herbal treatment for 2 months.

Treatment approach is to expel wind-cold in the Bladder Taiyang channel, treat locally on the face to unblock channels, tonify qi and blood and resolve damp.

Typical treatment: BL2, BL10, GB8, ST4, ST5, ST6, DU14, DU20, SJ17, Yu Yao, SP6, ST36, LI4. Other points included are ST40, SJ5, SI19, SJ23, DU16, GB2. A technique of pulling the drooping eyelid up prior to needling is used. Local eye and mouth points are used on the right side. Electro-acupuncture is used on the face from the eighth treatment onwards when she had more qi and blood to support stronger stimulation. The electro-acupuncture setting is 100/2 hertz with mixed macro amp for 20 minutes. Typical electro-acupuncture points connect SJ17 to DU16 and ST3 to ST5. 

Jing Fang Bai Du San and Chuan Xiong Wan are given for 2 weeks to expel wind-cold. Jing Fang Bai Du San tablets are given for 3 days, TID. Then Chuan Xiong Wan tablets are given for 11 days, TID. 

The formula is then switched to Gui Pi Wan for 2 weeks to tonfiy qi and blood. Xiang Sha Liu Jun Zi Tang is given for a week, afterwards, to tonify Spleen qi and move damp. 3 weeks of Yu Ping Feng San is given after the last acupuncture treatment to tonify wei qi.

Patient is advised to eat more meat, egg or alternative protein in order to increase her energy, qi and blood. Patient is also advised to do facial exercises of saying “A, E and O.”


At the fourth consultation, the patient reported that there was no more pain in her forehead, with only an occipital headache. Her sense of taste returned. She reported not feeling the needles on the right side of her face during the initial treatment, but could now feel the needles.

Her demeanour and energy appeared much better. Her eyelid drooped down to cover 1/8 of her eye and she was able to close her right eye ¾ of the way. She was finally willing to show her smile. It was asymmetrical. The right side of her mouth was still expressionless and the left side tight. The patient could now differentiate between sharp/dull sensations on the affected side. The patient’s tongue had a red tip, thick white coat and no tremor.

From treatment-to-treatment, there was considerable improvement. There were visible improvements of the eye and mouth. With each visit, she had more strength in her voice, and color in her face.

On the eighth treatment, she asked if she could discontinue treatment since she felt 80% better. Her eye and forehead had the most significant improvements, though the patient’s mouth was still asymmetrical. Her pulse was weak, but stronger than before.

She was advised to come for the full 10 treatment since she was not fully recovered. At the tenth treatment, all tests were performed and an improvement was shown in all the tests. The patient could close her eyes fully and blink properly. Facial expressions of raising the eyebrows were symmetrical. Sharp/dull sensory tests showed the same sensations on both sides. Motor facial tests of saying the sound “E” and “O” showed slight asymmetry of the mouth. Patient reported a good appetite. She was sleeping 9 hours per night without interruption, she had more energy and her body felt lighter. There was slight pain behind the right ear and the left side of the mouth was slightly tight.

After 10 acupuncture treatments, she was not able to come anymore. Therefore, 3 weeks of Yu Ping Feng San was prescribed.


This patient showed rapid improvement from acupuncture and herbal medicine for Bell’s palsy. She showed a significant improvement from acute Bell’s palsy with herbal medicine and 10 acupuncture treatments 2- 3 times per week for 5 weeks. The patient was given 3 weeks of herbal medicine to boost her immune system after her 10th
acupuncture treatment. For this patient, 20 acupuncture treatments would be a more appropriate course of treatment. 90% recovery was shown with 10 treatments. If recovery is to follow the same course, full recovery may be possible at 15 acupuncture treatments; and 5 more treatments after to strengthen her immune system. This case demonstrates that with early diagnosis, and continuous and frequent treatment of acute Bell’s palsy using acupuncture and Chinese herbal medicine, significant results are highly possible.

Acupuncture Case Study

3rd visit - eye closed half way


Acupuncture Case Study

6th treatment - saying the sound “E”


Acupuncture Case Study

8th treatment - eye closed with no gap
More color in face, more energy, gained weight


Acupuncture Case Study

10th treatment- saying the sound “E”






  • Acute Cholecystitis

    Acute Cholecystitis

    70-year-old female presents with acute abdominal, chest and scapular pain, vomiting and diarrhea. At the local hospital, she was diagnosed with acute cholecystitis via labs and ultrasound

    Read More
  • Ankylosing Spondylitis

    Ankylosing Spondylitis

    25-year-old male presents with low back and sacroiliac pain, beginning approximately 15 months prior to consultation at this clinic, for which he had received a diagnosis

    Read More
  • Atrophic Vaginitis with Recurrent Urinary Tract Infections

    57-year-old post-menopausal female presents with constant burning uterine and bladder pain for 3 years. Allopathic care has been unsuccessful in diagnosing and providing relief of symptoms

    Read More
  • Autism Spectrum Disorder

    Autism Spectrum Disorder

    20-year-old male patient presents with decreased mental capacity, which his mother states has been present since birth. He lacks verbal communication skills and his mother states

    Read More
  • Bell’s Palsy (Facial Paralysis)

    Bell’s Palsy (Facial Paralysis)

    A 50-year-old female with Bell’s palsy presents with hemi-facial paralysis involving the eye and the mouth. After 5 weeks, 10 acupuncture treatments and 2 months of

    Read More
  • Bilateral Hip and Low Back Pain

    19-year-old male presents with trauma-related chronic hip and low back pain with limits in range-of-motion that interferes with daily life. After 24 acupuncture treatments over the

    Read More
  • Bilateral Leg Weakness and Paralysis

    Bilateral Leg Weakness and Paralysis

    42-year-old female presents with an inability to walk due to slow-onset, partial bilateral leg paralysis occurring over a 15 year time span. After 23 treatments focusing

    Read More
  • Candidiasis and Vaginal Discharge (Type II Diabetes)

    Candidiasis and Vaginal Discharge (Type II Diabetes)

    63-year-old female presents with chronic purulent vaginal discharge, pruritus vulva and tingling in the extremities. Test results show hyperglycemia of RBS 540 mg/dl as well as

    Read More
  • Cervical and Lumbar Spondylosis

    Cervical and Lumbar Spondylosis

    70-year-old male presents with severe cervical and lumbar pain, neuropathy of the arms, hands, legs and feet, incontinence of bowels and anal rash. His doctor has

    Read More
  • Chronic Abdominal Pain

    Chronic Abdominal Pain

    31-year-old male presents with chronic abdominal pain. The patient has suffered from abdominal pain for the past 11 years, but has had a worsening of symptoms

    Read More
  • Chronic Gastritis

    Chronic Gastritis

    52-year-old female presents with chronic, burning epigastric pain accompanied by acid reflux, nausea, belching and decreased appetite. The patient also experiences daily headaches and dizziness. With

    Read More
  • Chronic Gastritis with Inflammatory Bowel Syndrome: Crohn’s Disease

    Chronic Gastritis with Inflammatory Bowel Syndrome: Crohn’s Disease

    40-year-old male presents with chronic, burning gastrointestinal pain with accompanied acid reflux, belching, fullness, diarrhea, weight loss and occasional rectal bleeding. The patient also experiences

    Read More
  • Chronic Headache (Typhoid Fever Sequela)

    Chronic Headache (Typhoid Fever Sequela)

    43-year-old female presents with a severe headache. 9 months ago, the patient contracted Typhoid fever. During the illness, she had a headache that covered her entire

    Read More
  • Chronic Non-Healing Ear Ulcers

    Chronic Non-Healing Ear Ulcers

    15-year-old female presents with purulent, non-healing ulcers in the right ear canal. After 20 treatments, using an integrative approach that included Chinese herbal medicine, acupuncture and

    Read More
  • Chronic Obstructive Pulmonary Disease with Osteoarthritis

    Chronic Obstructive Pulmonary Disease with Osteoarthritis

    65-year-old female presents with dyspnea and continuous cough. The patient also presents with chronic, severe pain and inflammation of all joints of the hands and feet.

    Read More
  • Chronic Vomiting

    Chronic Vomiting

    80-year-old male presents with vomiting 20 minutes after each meal for 2 years. At the time of initial visit, patient was vomiting undigested food and water

    Read More
  • De Quervain’s Syndrome

    57-year-old female presents with hand tingling and severe wrist pain that began 9 months prior to visiting the clinic. Both wrists are affected. Patient reports pain

    Read More
  • Dupuytren’s Contractures

    Dupuytren’s Contractures

    58-year-old male presents with persistent contraction of 3rd, 4th and 5th fingers of right hand. He reports it began insidiously 3 years ago, and that it

    Read More
  • Emotional Depression

    Emotional Depression

    40-year-old woman presents with depression, emotional stress and dream-disturbed sleep. She presents with a secondary complaint of chronic ringing in her ears. 2 months ago her

    Read More
  • Facial Paralysis (Bell’s Palsy)

    Facial Paralysis (Bell’s Palsy)

    35-year-old female presents with left-sided facial twitching and paralysis. After 7 acupuncture treatments, the patient regained over 50% of her facial functioning with 80% of the

    Read More
  • Febrile-Induced Cerebellar Ataxia

    Febrile-Induced Cerebellar Ataxia

    58-year-old male patient presents with ataxia, severe dizziness, vertigo and slurred speech. Symptoms started after a severe febrile illness in November 2012, and appear to be

    Read More
  • Ganglion Cyst

    Ganglion Cyst

    11-year-old female presents with large lump over left radial artery at radial styloid process, causing pain to the local area. She had minor surgery to remove

    Read More
  • Hemiplegia (Stroke Sequelae) with Acute Lung Consolidation

    Hemiplegia (Stroke Sequelae) with Acute Lung Consolidation

    81-year-old female presents with complete left-sided hemiplegia following ischemic stroke 2 months ago. Over the course of 7 weeks of acupuncture treatment, the patient regained limited

    Read More
  • Hemiplegic Stroke Sequelae with Aphasia

    Hemiplegic Stroke Sequelae with Aphasia

    Patient presents with right-sided paralysis of his upper and lower limbs due to an ischemic stroke 9 months ago. Additional sequela includes speech impairment with the

    Read More
  • Hemorrhagic Stroke Sequelae

    Hemorrhagic Stroke Sequelae

    53-year-old male presents with right-sided hemiplegia following a hemorrhagic stroke 1 year ago. Patient complaints include decreased range-of-motion, pain, numbness and weakness of his right side

    Read More
  • Huntington's Disease

    Huntington's Disease

    38-year-old female presents with a 4-year history of involuntary spasming throughout her entire body. The patient does not have any available medical records and the cause

    Read More
  • Ischemic Cerebrovascular Incident

    Ischemic Cerebrovascular Incident

    60-year-old male presents with sudden onset of motor deficit of right hand, tingling and weakness of right foot, as well as marked changes in function of

    Read More
  • Juvenile Rheumatoid Arthritis

    Juvenile Rheumatoid Arthritis

    10-year-old female presents with active phase of Juvenile Rheumatoid Arthritis (JRA) as demonstrated by multiple articular bony joint deformities, severely limited range-of-motion in all affected joints,

    Read More
  • Low Abdomen Pain due to Roundworm and Urinary Infection

    Low Abdomen Pain due to Roundworm and Urinary Infection

    30-year-old female presents with lower abdominal pain, burning urination and shortness of breath for the last 5 months. With the discovery and treatment of a parasitic

    Read More
  • Low Back Pain with Radiation

    Low Back Pain with Radiation

    30 year old male presents with severe back and left leg pain, exhibiting postural deviation as a way to relieve pain from an L5/S1 disc herniation.

    Read More
  • Low Back Pain with Urinary Difficulties

    Low Back Pain with Urinary Difficulties

    32-year-old woman presents with constant low back pain and burning urination. She has been diagnosed with severe hydronephrosis in the right kidney and, due to pain,

    Read More
  • Lumbar Stenosis due to Osteoartritis

    Lumbar Stenosis due to Osteoartritis

    36-year-old female with lumbar spinal stenosis presents with severe low back pain with referred pain down the posterior left leg and anterior right thigh. The patient

    Read More
  • Massage for Chronic Back Pain Associated with Spondylosis of the Spine

    Massage for Chronic Back Pain Associated with Spondylosis of the Spine

    70-year-old male referred for massage treatments for pain associated with spondylosis of the spine and neuropathy. The patient is simultaneously receiving ongoing acupuncture treatments. At the

    Read More
  • Neck Pain with Radiation

    Neck Pain with Radiation

    40-year-old male presents with right-sided neck pain, without nerve radiculopathy, down the arms bilaterally. He has seen his physician who diagnosed him with nerve impingement and

    Read More
  • Outer Ear Infection

    Outer Ear Infection

    52-year-old male presents with right-sided, burning head and ear pain, right-sided hearing loss and anosmia. It is determined, after an initial ear examination with an otoscope,

    Read More
  • Painful Ulcerations of the Throat with Chronic Sinusitis

    28-year-old male presents with chronic sinusitis, nasal blockage, throat pain and ulcerations for 18 months. The patient also presents with gastric pain. After 9 acupuncture treatments

    Read More
  • Palliative Care of Parkinson’s Disease

    Palliative Care of Parkinson’s Disease

    62-year-old male was diagnosed with Parkinson’s disease 8 years ago and has been receiving treatment in this clinic since 2009. This case explores the positive role

    Read More
  • Palliative Management of End-Stage Emphysema

    Palliative Management of End-Stage Emphysema

    71-year-old male presents with cough and severe shortness-of-breath, caused by emphysema. Initially, patient was stabilized during an emergency home visit. At patient’s request, palliative home care

    Read More
  • Parkinson’s Disease

    Parkinson’s Disease

    72-year-old female presents with left hand tremors that extend up the arm and into her neck and jaw. Tremors have been present for 2 to 3

    Read More
  • Primary Hypertension

    Primary Hypertension

    3 patients present with stage 2 essential hypertension (HTN), 1 of which is a female (76 yo) and 2 of which are male (61, 50 yo).

    Read More
  • Psoriasis with Neck and Shoulder Pain

    Psoriasis with Neck and Shoulder Pain

    45-year-old male presents with psoriasis for 5 years, possible psoriatic arthritis for 2 years, and idiopathic neck pain and stiffness for 2 months. After 17 treatments

    Read More
  • Rheumatoid Arthritis

    Rheumatoid Arthritis

    35-year-old female presents with multiple bilateral joint pain beginning 18 months previously and had received a diagnosis of rheumatoid arthritis at the Arthritis & Rheumatic Diseases Treatment

    Read More
  • Sequelae of Osteoarticular Tuberculosis

    Sequelae of Osteoarticular Tuberculosis

    Rachael Haley BAppSci (TCM)December 2014 OVERVIEW A 58-year-old man, of rural Nepal, presents with left hip pain, reduced strength and mobility in his left hip and

    Read More
  • Spastic Quadriplegic Cerebral Palsy

    Spastic Quadriplegic Cerebral Palsy

    Severely malnourished and non-ambulatory 11-year-old female presents with increased tone and spasticity in all extremities, frequent seizures, and currently requiring assist for all mobility. Patient was s

    Read More
  • Spinal Trauma Sequelae with Osteoarthritis of Right Knee

    60-year-old female presents with spinal trauma sequela consisting of constant mid- to high grade pain and restricted flexion of the spine. In conjunction with the treatment

    Read More
  • Stroke Sequela

    Stroke Sequela

    50-year-old male presents with post-stroke sequelae symptoms manifesting as severe right-sided paralysis. After 10 treatments starting in September 2012, the patient exhibited improvement in his condition

    Read More
  • Typhoid Fever Induced Paralysis

    Typhoid Fever Induced Paralysis

    32-year-old female presents with left-sided paralysis of upper and lower limbs. At age 12, the patient suffered from a fever due to Typhoid that caused convulsions

    Read More
  • Ulcerative Colitis

    Ulcerative Colitis

    70-year-old female patient presents with urgent, frequent diarrhea. No enteropathogenic organisms are present, however blood is found in the stool. Allopathic care has been unable to

    Read More
  • 1

Compendium of Clinical Case Studies

clinical case studies

Download our entire collection of clinical case studies.

View FlipbookDownload PDF

Your Donations Help

In addition to volunteering their time and energy, our practitioners are required to raise the money it takes to support their efforts at our clinic. Please consider helping them by making a tax deductible donation in their name.


Support our work

Donate Volunteer Get in Touch

Support Us