Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

Clinical Application:
Trigenimal Neuralgia
Trigeminal

neuralgia

letting blood from these vessels by puncturing themwith the tip of No. 4-5 needles. This kind of bloodisa

lancinating

painoccurring in the area innervated by the trigeminal
nerve that continues for short periods of time and isfrequent in the elderly. The pain usually lasts only afew seconds, occurs suddenly and then disappears
suddenly.

Western

pharmacotherapy,

medicalsurgicalapproaches

treatmentandinclude
nerve

blocks; but neither of these treatment forms is 100%effective. Acupuncture and moxibustion treatment iseffective, but the condition still remains intractable.
Nevertheless, when various treatments have been
tried without providing any relief, it may be possible toinduce some relief, or in some cases, even cure thecondition. Several treatment forms have been tried.
Bunshi Shirota recommended and performed thefollowing treatment1).
First, treat the acuppoints CV12, BL20, GV12,
TE15, LI11, GV34, etc. with acupuncture andmoxibustion for the purpose of adjusting the generalbody condition.
For the treatment of the first branch, the ocularnerve (causing pain of the upper eyelid, forehead up tothe vertex; eye socket, eye bulb, tip of the nose, nasalcavity), the acupoints BL2, GB14, TE23, GB3, GB16,
BL10, etc. on the affected side are needled, while thepoint BL2 is also needled on the healthy side.
Moxibustion:

GB16, GB5, TE22, GB12, TE17,

BL10, Sawada style LI4 and similar points are treatedwith moxibustion. In case of a neuralgia of the firstbranch in particular acupuncture and moxibustion
treatment of the point BL10 should not be forgotten.
This may induce a sudden relief of the pain.
For the treatment of the second branch, themaxillary nerve (pain in the lower eyelid, buccal region,
upper lips, nasal wings, anterior portion of the parietalbone, upper row of the teeth. Pain of the pallate, nasal

letting frequently induces a sudden relief of the pain.
For the treatment of the third branch, themandibular nerve(paininthementalregion,

mandibular region, inferior dental alveoli, external ear,parietal region etc.) ST7, ST6, ST5, ST4, Ikoten, GB2,etc. are needled on the affected side, while moxibustion
is applied to GB2, TE17, L97, Sawada style LI4, etc.
For the treatment of the second and third branch,needling of SI18, ST7, ST5, etc. on the healthy side or
somewhat strong manipulation on the affected sidecan provide some relief of the pain.
In Meridian Therapy (channel based treatment)
deficiency and repletion of the various channels areadjusted and reactive points treated with acupunctureand moxibustion. Sodo Okabe reported the following.
The first branch of the trigeminal nerve is governed by
the bladder and stomach channels, the second branch
by the stomach, gallbladder and tripple heater
channels and the third branch by the large intestineand stomach channels. Reactive points for the firstbranch include BL2, for the second branch ST1 AND
ST2, Shihaku and for the third branch ST5, ST6 AND
CV24. Needle retaining is probably most suitable forthe treatment of trigeminal neuralgia. From theaffected painful regions stiffness and muscle tension
spreads over the parietal region, covering neck,shoulderandback.

Searchingtheseareasforindurations and tenderness allows to select thetreatment points and needles have to be retained here
until the pain disappears2).
Okabe determined the basic acupoints required forthe treatment of this disease and conducted histreatment following the relevant pattern. He stated
the following "Select reactive points from among thebasic points including GB14, ST1, BL2, GB3, ST7,LI20, ST6, SI18, CV24, Iko, ST9, LI18, BL10, GB20,

cavity etc.) on the affected side GB3, ST7, SI18, ST3,GB21, BL12, GV14, BL11, BL43 and LI15 for theLI20, etc. are needled, TE22, SI19, GB5, TE17, LI10,treatment."

etc. are treated with moxibustion. Furthermore, if

The relevant patterns can be divided into two

there are any fine visible vessels micropuncturing intypes. The first type is the greater hand yin pattern,

the buccal region, it could be beneficial to attempt

for which SP4, ST44, LI10, LI11, ST36, LI4, LU7 and

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

67

Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

similar points are selected. The second type, the lesser
foot yin pattern, for which KI10, KI7 and KI3, etc. areOkabe was invited in February 1973 to theneedled. The point LI15 is effective for facial edema(former) Soviet Union and went to Moskow toand should be treated with a large number of moxa

treatcones.

trigeminal neuralgia. At that time his patient wasGeneral

Zhukov,

whosufferedfromOkabe also stated the following. "Even for diseases

about 77 years old. The trigeminal neuralgiaof the upper half of the body the conditions will notreportedly affected the entire left side of the face

improve properly unless the patterns for liver, kidney,

and neck the patient had been in pain for about 5lung and spleen deficiency are adequately identified.

years. Okabe needled important points for theLocal treatment alone certainly does have some effect,

first, second and third branch of the nerve to a

but will not lead to a general improvement. Both indepth of about 2-3 mm while tonifying both kidneycases of trigeminal neuralgia as well as paralysis, theand liver channels. He said that in these cases thechannels on both the affected and healthy side have toarea

be needled in order to adjust them, even if the affected

importantarea is limited to one side of the body."3)experience, that needling of the neck can provide

from theandneckupwards

believes,

based

isextremelyonpersonal

considerable relief of the facial pain. Thus, theReferences
１

２
３
４

condition of General Zhukov improved constantly

Shirota B.: Practical Acupuncture andday by day and Okabe returned to Japan three

Moxibustion Therapy Based on Case Reports,months later. In September he went again to theVol. 1, p.385-394, Sogensha 1966

Soviet Union, spent about 2 weeks there and theOkabe S.: Channel Therapy with Acupuncture

treatmentand Moxibustion p.119-121, Sekibundo 1974

recovery4). This story was derived from an essayOkabe S.: The Essence of Acupuncture andcollection written by Okabe himself. It shows, thatMoxibustion Therapy, p.90, Sekibundo 1983

he apparently diagnosed a foot lesser yin pattern,

Publication group for an anthology of works intonified the correlated liver channel, and needledmemory of Sodo Okabe: Okabe S.: p.84-89,

important points on the face.

resultedTosho Printing Company, Limited 1985

68

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

inanalmost

complete