We report a 74-year-old woman who developed right-sided Hunt syndrome on July 3, XXXX, and who received stellate ganglion block and an infusion of aciclovir while hospitalized. Steroids were not used due to her diabetes. After discharge, she continued taking vitamin B12, and received stellate ganglion block three times a week, but the paralysis did not show a tendency toward recovery. Following a combination of acupuncture and rehabilitation starting on October 6 (post-onset day 95), the paralysis score, which was 4 points on day 95, showed a tendency toward recovery : 32 points on day 186, and 36 points or more (within the normal range) on day 246. No apparent synkinesis was seen one year after the onset. Although Hunt syndrome appeared to be refractory due to her advanced age, presence of diabetes, unused steroids, complete paralysis with a paralysis score of 8 points or less, and no tendency to recover for three months or more, the results suggested that she responded to the combination of acupuncture and rehabilitation. acupuncture, rehabilitation, Hunt syndrome, refractory
We retrospectively investigated the effects of acupuncture on refractory peripheral facial paralysis. Among patients with Bell's palsy or Ramsay Hunt syndrome (type II) who underwent acupuncture between August 1996 and June 2004, were 29 patients with a minimum electroneuronography (ENoG) percent response of 0%, and NET scale-out (14 patients with Bell's palsy, 15 with Ramsay Hunt syndrome). Demographically, they 21 males and 8 females, with a mean age of 44.3±12.8 years. Their disease duration, and paralysis score assessed using the 40-point method (Yanagihara's method) were 43.2±23.9 days and 10.2±2.7 points, respectively. To evaluate treatment response, we employed the paralysis score, and a sequela score assessed using a modification of the sequela evaluation method designed by Nishimoto and Murata et al. The paralysis score exceeded 36 points within 6 months after onset. Five patients (17.2%) without sequelae were regarded as having achieved complete recovery, and 24 (82.8%) as having achieved incomplete recovery. When the minimum ENoG is 0%, recovery within 6 months beyond onset is considered impossible. The results suggest, however, the efficacy of acupuncture. Refractory, peripheral facial paralysis, Bell's palsy, Ramsay Hunt syndrome, minimum ENoG of 0%, NET scale-out, acupuncture
To help medical doctors practicing Kampo medicine suggest appropriate acupuncture treatments for individ ual patients, a study group made up of 7 acupuncturists and 5 medical doctors developed an acupuncture cur riculum. The group provided a learning program based on the curriculum for 16 medical doctors in charge of outpatient Kampo services in a research institute. The learning program consisted of a lecture and practical training, and a total of 4 sessions were held. At the end of each session, a test was conducted to examine the participants' level of understanding. After the completion of the learning program, a questionnaire survey was conducted to confirm the usefulness of the acupuncture curriculum for the practice of Kampo medicine. The mean number of participants per session was 10.8 ± 1.3. The mean test score was 9.3 ± 0.5 (full score : 10). In the questionnaire, 14 out of the 16 (88%) answered that the acupuncture curriculum was useful or relatively useful for the practice of Kampo medicine. On comparing the numbers of new acupuncture patients with a his tory of outpatient Kampo service use before and after the acupuncture curriculum, there was a 1.8fold in crease after it. The results support the usefulness of the acupuncture curriculum to understand acupuncture and practice Kampo medicine. Further evaluation is necessary.
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