As early as 1979, the World Health Organization identified and recommended 43 diseases suitable for acupuncture treatment, including “facial palsy”, and believed that the principle of acupuncture treatment for facial palsy is to stimulate the facial nerve, dilate blood vessels, and mediate the local meridians and blood vessels of the face, so as to promote blood circulation and make facial palsy recover from itself. However, in clinical practice, we encounter some patients who are not cured by acupuncture, and are left with different degrees of sequelae, which cause physical and psychological harm to the patients. So why is acupuncture a strong and preferred treatment for facial palsy and why is it not effective for some patients? This is related to many aspects, the following I will give you: First of all, a simple understanding of the local distribution of the facial nerve. The nucleus of the facial nerve is divided into two parts: the upper part of the tissue receives innervation from the motor areas of the cerebral cortex on both sides, and the motor fibers emitted from it innervate the muscles around the eyes; while the lower part of the tissue receives innervation from the motor areas of the cerebral cortex on the opposite side only, and the motor fibers emitted from it innervate the muscles around the mouth and lips. When lesions occur in the tissues above the facial nerve nucleus, i.e., cerebral cortex, brainstem, internal capsule, etc., it can be manifested as paralysis of the muscles around the mouth and lips on the opposite side of the lesion. The eye muscles on that side are not affected. The eye muscles on that side are not affected, which means that the muscles around the eyes are not affected and are normal. In most cases, damage to supranuclear tissues (including the cortex, cortical brainstem fibers, internal capsule, brain bridge, etc.) causes paralysis of the lower facial muscles on the opposite side of the lesion. It is often seen in cerebrovascular lesions, brain tumors and encephalitis, and is called “central facial palsy”. It is commonly seen in the sequelae of stroke caused by hypertension, cerebral arteriosclerosis, cerebral thrombosis, cerebral infarction, brain tumor, traumatic brain injury, and inflammation in the brain. In addition, there are also atrial fibrillation caused by wind heart disease and cerebral embolism caused by dislodged emboli of bacterial endocarditis. And of course there are accompanying symptoms of different diseases, such as hemiplegia, aphasia, high blood pressure, heart murmur, etc. When lesions occur below the facial nerve nucleus, the periorbital muscles innervated by the upper part of the facial nerve nucleus and the periorbital muscles innervated by the lower part of the facial nerve nucleus will be involved at the same time, i.e., the phenomenon of simultaneous paralysis of the upper and lower muscles on one side will be manifested. The clinical manifestation is the inability to wrinkle the forehead, frown, loss of corneal reflex, weakness or complete inability to close the eyelid, resulting in constant tearing, shallowing of the nasolabial fold, inability to show teeth, puff cheeks, whistle, and drooping of the corners of the mouth (or the corners of the mouth are skewed to the opposite side of the lesion, i.e., the opposite side of the paralyzed facial muscles), and also impairment of taste in the anterior 2/3 of the tongue. It is caused by damage to the facial nerve nucleus or facial nerve, and all facial muscles on the same side of the lesion are paralyzed. It is called “peripheral facial palsy”, “simple facial palsy”, and “facial neuritis”. Generally speaking, if it is “central facial palsy.” The possibility of complete recovery is low, and there will be some sequelae. In the case of “peripheral facial palsy”, the chance of having sequelae is very small. The choice of timing and method of acupuncture treatment will have a direct impact on the outcome and prognosis. To reduce the chance of sequelae of facial palsy, it is important to detect early and to go to the acupuncture department of a regular hospital to receive systematic and standardized acupuncture treatment. We have already known the local distribution of the facial nerve and that facial palsy is caused by damage to the peripheral facial nerve caused by the facial nucleus, which cannot innervate the facial muscles. At the beginning of the disease, the facial nerve is only a localized lesion in the aforementioned area, and the facial muscles are normal, only that the neural command system is impaired and cannot function normally. From the perspective of Chinese medicine, whether the facial palsy is caused by wind-cold or wind-heat, the root cause is the patient’s own weakness of positive energy and the void of blood and qi, resulting in the loss of nourishment of the facial muscle. The art of acupuncture is to regulate and unblock the meridians by “tonifying the deficient and dipping the real”, so that the qi and blood can be balanced and run normally to moisten the affected facial muscles. Electro-acupuncture is the product of the combination of modern medicine and traditional medicine. The pulse current output of the electro-acupuncture device acts on the acupuncture points, meridians or a specific part of the body through the milli-needle to achieve the treatment of diseases. Today, the use of electro-acupuncture has become a common technique used by some doctors to treat facial palsy (including, of course, many acupuncture indications), and is the “culprit” for the sequelae of facial palsy. We know that under normal physiological conditions the nerve membrane is semi-permeable, with cations on the surface of the membrane and anions inside the membrane. If inappropriate and frequent electroacupuncture stimulation is used in the affected area, the permeability of the nerve membrane will be accelerated and the phenomenon of depolarization will occur, resulting in changes in the permeability of the facial nerve membrane and the rearrangement of the anions and cations to cause continuous congestion in the local tissues, which reduces the excitability of the nerve and fatigues the facial nerve cells and causes edema in the muscles of facial paralysis, which is not conducive to recovery. When the lesioned facial nerve is overly stimulated by local electrical stimulation or over-frequent and over-strong tremors, it may cause complete degeneration of the facial nerve and may lead to sequelae such as mouth-eye linkage, contractures and spasms on the affected side. So I remind you that although in the acute phase of facial nerve palsy should be early intervention preferred acupuncture method of treatment, but for its stimulation intensity is much greater than hand twisting, the rehabilitation of the muscles and repair of damage to the nervous system has a certain role, but will be due to repeated improper, frequent and prolonged repeated use of electroacupuncture stimulation will make the right qi more injury, the evil qi stay, broken qi injury blood, which occurs in the affected muscle adaptation phenomenon (muscle fatigue ), but aggravated the condition, greatly increasing the likelihood of sequelae, increasing the difficulty of treatment. The use of electro-acupuncture should be done with caution. Of course, the use of electroacupuncture in the sequelae of facial paralysis is a different story. The third point is the patient’s own problem. If the patient has a poor physical condition and has been sick for many years, or has diabetes, cardiovascular disease, etc., it is not good for the recovery of facial palsy. Then there is the patient’s “fear” of leaving sequelae, “multi-pronged” under the “concern” of colleagues, friends, relatives, and multiple medical treatment, can not jump down the heart with a method of treatment, will be The muscle function of the affected part will not be restored, but the disorder will be aggravated, leading to the occurrence of sequelae. Although facial palsy is not a major disease, it affects the aesthetics of the patient, so most patients (especially young women) cannot accept it, and after the onset of the disease, there will be mental tension, abnormal emotions, worries, eagerness to heal, changes in life and work patterns, lack of sleep and other extreme “mind and soul” performance. According to Chinese medicine, “the heart is open to the face”. As a result of “mind and soul restlessness”, the outer orifice of the heart will be under tension for a long time and cannot be relaxed, which is also unfavorable to the recovery of facial palsy. According to a survey conducted by the relevant authorities, psychological factors are one of the important factors triggering facial palsy. In addition, during the whole treatment process, patients frequently rub the affected facial muscles with their hands, once the rubbing causes the affected muscles to sag, it is impossible to recover. In addition, not paying attention to the avoidance of cold water gargling and face washing, avoiding cold and spicy food, avoiding wind and cold in the affected area, and keeping the area warm are also major causes of the sequelae. Some people may ask if the treatment of facial palsy will leave sequelae if western doctors use vitamin B1, vitamin B12, niacin, prednisone, virazole, antibiotics and other drugs. Through clinical observation, this method can only be regarded as a symptomatic and comforting treatment, especially in the early stage of facial palsy onset, intravenous drip is not a good idea. Most of the patients who seek acupuncture after poor results of oral and intravenous drip treatment with western drugs not only have poor results, but also have side effects such as weakness, lethargy and drowsiness in 2 weeks, which bring many disadvantages to the excitement and repair of facial muscles. There are also large measures of improper application of hormones are inappropriate. In addition to these reasons, facial nerve degeneration caused by severe herpes of the ear, viral invasion of the geniculate ganglion, and damage to nerve fibers is a symptom of facial palsy that is difficult to reverse; facial palsy caused by compression of the facial nerve by osteoma of the external auditory canal, middle ear cholesteatoma, and auditory nerve sheath tumor; facial nerve damage caused by surgery such as middle ear tumor resection and mastoid radical surgery, etc. is also difficult to be treated by acupuncture.