Xu Benren, Ge Shuhan (Shenyang Air Force Hospital of PLA)
All the 225 cases were diagnosed clinically as idiopathic trigeminal neuralgia since we could find neither etiological factors, nor any physical signs. The paroxysm of pain was limited to the distribution of the trigeminal nerve, occuring as cutting, burning or lightening-like stabs and lasting for several seconds to 2-3 minutes or even longer. A trigger point was usually present and, in some cases, facial spasm swelling and redness of the face, tearing or salivating were accompanied.
Of the 225 cases, the duration of disease varied, the longest being over 40 years and the shortest only one week.
134 patients complained of pain on the right side of the face, 84 on the left and 5 on both. Pain of the 1st branch of trigeminal nerve were seen in 8 cases, the 2nd branch in 40, 3rd branch in 20, both 1st and 2nd branches in 27, both 2nd and 3rd in 106 and all the three branches in 24 cases.
Method of treatment
1. Neuralgia of the 1st branch.
Point: Foramen orbitalis superior.
Method of needling: A needle (No. 26) 2.5 cm in length was inserted into this point inwardly and downwardly about 0.3-0.5 cm in depth. When a lightening-like feeling of the needling is transmitted to the eye and forehead, the needle is manipulated up and down for 20-50 times.
2. Neuralgia of the 2nd and 3rd branches.
Point: Xiaguan.
Method of needling: Insert a needle (No. 26) 5.0 cm in length at this point. In case of the neuralgia of the 2nd branch, the tip of the needle is directed toward the opposite eyeball, and manipulated up and down for 20-50 times when a lightening-like feeling is transmitted to the upper lip of the patient. In case of neuralgia of the 3rd branch, the needle is inserted perpendicularly at the same point. Manipulate the needle up and down for 20-50 times when a same feeling of the needling is transmitted to the lower jaw.
If this method fails in the treatment of the neuralgia of the 2nd branch, another point Sibai may be selected or added. Insert a needle (No. 26) 2.5 cm in length into this point backward and upward at an angle of 45ยบ and 1.8-2.0 cm in depth. Manipulate it up and down for 20-50 times when a lightening-like feeling is transmitted to the upper lip.
In all cases the acupuncture is given every other day and a course of treatment includes 10 needlings.
Therapeutic results
Relief of pain in 75 cases (33.4%), markedly improved in 111 cases (49.6%), improved in 35 cases (15.5%) and ineffective in 4 cases (1.5%).
Follow-up observation
165 cases were followed up for more than half year. Among the 75 cases completely relieved from pain, 15 cases had recurrent attacks during the period of two months to one year after the treatment. Acupuncture was repeated again for these 15 patients and 6 were completely relieved, 4 markedly improved, and 5 improved.
All the 225 cases were diagnosed clinically as idiopathic trigeminal neuralgia since we could find neither etiological factors, nor any physical signs. The paroxysm of pain was limited to the distribution of the trigeminal nerve, occuring as cutting, burning or lightening-like stabs and lasting for several seconds to 2-3 minutes or even longer. A trigger point was usually present and, in some cases, facial spasm swelling and redness of the face, tearing or salivating were accompanied.
Of the 225 cases, the duration of disease varied, the longest being over 40 years and the shortest only one week.
134 patients complained of pain on the right side of the face, 84 on the left and 5 on both. Pain of the 1st branch of trigeminal nerve were seen in 8 cases, the 2nd branch in 40, 3rd branch in 20, both 1st and 2nd branches in 27, both 2nd and 3rd in 106 and all the three branches in 24 cases.
Method of treatment
1. Neuralgia of the 1st branch.
Point: Foramen orbitalis superior.
Method of needling: A needle (No. 26) 2.5 cm in length was inserted into this point inwardly and downwardly about 0.3-0.5 cm in depth. When a lightening-like feeling of the needling is transmitted to the eye and forehead, the needle is manipulated up and down for 20-50 times.
2. Neuralgia of the 2nd and 3rd branches.
Point: Xiaguan.
Method of needling: Insert a needle (No. 26) 5.0 cm in length at this point. In case of the neuralgia of the 2nd branch, the tip of the needle is directed toward the opposite eyeball, and manipulated up and down for 20-50 times when a lightening-like feeling is transmitted to the upper lip of the patient. In case of neuralgia of the 3rd branch, the needle is inserted perpendicularly at the same point. Manipulate the needle up and down for 20-50 times when a same feeling of the needling is transmitted to the lower jaw.
If this method fails in the treatment of the neuralgia of the 2nd branch, another point Sibai may be selected or added. Insert a needle (No. 26) 2.5 cm in length into this point backward and upward at an angle of 45ยบ and 1.8-2.0 cm in depth. Manipulate it up and down for 20-50 times when a lightening-like feeling is transmitted to the upper lip.
In all cases the acupuncture is given every other day and a course of treatment includes 10 needlings.
Therapeutic results
Relief of pain in 75 cases (33.4%), markedly improved in 111 cases (49.6%), improved in 35 cases (15.5%) and ineffective in 4 cases (1.5%).
Follow-up observation
165 cases were followed up for more than half year. Among the 75 cases completely relieved from pain, 15 cases had recurrent attacks during the period of two months to one year after the treatment. Acupuncture was repeated again for these 15 patients and 6 were completely relieved, 4 markedly improved, and 5 improved.
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