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Posted on Friday, April 23, 2004 - 15:15:   

I have a patient that has been suffering with trigeminal neuralgia for 10 years. Since she started with acupuncture, her progress has been very slow and she stopped for the christmas holidays. He has started up again and still her progress is slow, with some regression from the stoppage in treatments.
He is in her 50's and has had a craniotomy, teeth extractions, and medications to help with the pain. She is worse with stress and heat.
Her pain starts at Du 26, runs along her upper lip, across ST 2 and to the lateral aspect of her eye, over to ST 7 and down to ST 4. I have used combinations of points both distal and local and also included ear points from time to time,
My question is: have you ever treated someone like this, and how did you go about treating them and the outcome. I am expecting a long term course with slow progress, as she has had this for a long time. I just want to know how others would deal with this situation.
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Shmuel Halevi
Posted on Friday, April 23, 2004 - 18:55:   

Hi A. In this disorder it is less important to differentiate classical patterns of Zang-Fu, rather follow the energetical characteristics manifesting in any particular case. The differentiation of whether she likes or dislikes cold or heat is very important, as well as if she likes massagae on her face or not, or whether the pain comes after exertion or after rest etc. These considerations will help you determine the nature of the treatment that you apply. Second, excellent needle technique is very important in this case and it goes in parallel with the differentiation conclusion mentioned above. Mostly, a two-points-combining or HuiCi needle technique is appropriate for such pain syndromes. Third, a patient with such a history as you have cited above, may take quite a time to cure in any event. If you have a more specific differentiation I may be able to extend a more detailed advice but then, the treatment becomes more self-evident, does it not ? In general, the principle is to apply needles along the route of the pain, I usually don't incline to the opposite side puncturing, and aid with powerful distant points such as Hegu, taichong etc.

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