Acupuncture Treatment for Pseudobulbar Palsy

Pseudobulbar palsy is a serious complication of cerebrovascular disease, occurring due to bilateral damage to the medullary tracts in recurrent strokes or a single stroke affecting the brainstem, disrupting the bilateral corticobulbar tracts. This leads to upper motor neuron damage involving the nucleus ambiguus (controlling pharyngeal muscles) and the hypoglossal nucleus (controlling tongue muscles), resulting in a group of symptoms centered on the tongue and throat. Manifestations include central paralysis of the tongue, soft palate, pharynx, face, and masticatory muscles.Prescription: Acupuncture therapy. Fengchi (GB20), Fengfu (GV16), Yammen (GV15), Tianzhu (BL10), Lianquan (CV23). Operation: Insert needle at Fengchi pointing toward the throat, gently rotate and slowly advance 1.5–2 cun, applying light, rapid reinforcing technique for 1–3 minutes, aiming for a sensation of numbness and distension in the throat and tightening of the uvula. Lianquan (CV23) is inserted 1.5 cun, directed toward the root of the tongue, with the depth adjusted to produce numbness and distension in the tongue root, using gentle rotation and slow insertion, preferably applying a reducing technique.Additions: For excessive phlegm and saliva, add Fenglong (ST40); for stiff tongue and slurred speech, add Jinjin (EX-HN11) and Yuye (EX-HN12); for uncontrollable laughing or crying, add Shenmen (HT7), Daling (PC7), Zhongchong (HT9), Shaoshang (LU11), Chize (LU5). For difficulty in elevating the soft palate, use a tongue depressor to push the tongue downward and backward, then use a 3-cun filiform needle to puncture the drooping soft palate, promoting removal of stasis and regeneration of new tissue.