Auricular & Scalp Acupuncture Review. ACR class 13. Auricular. Anatomy & Somatatopic Representation. Modern Auriculotherapy founded by Paul Nogier in 1950â€˜s France Also developed in 1960â€™s China Some differences in point location but overall very similar
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Auricular & Scalp Acupuncture Review • ACR class 13
Modern Auriculotherapy founded by Paul Nogier in 1950‘s France • Also developed in 1960’s China • Some differences in point location but overall very similar • Fetal / “Upside-down man” representation
Lobe: Face & sensory • Antitragus: Cranial & brain • Internal organs in concha: • Thorax = Inferior (Cavum) concha • Abdomen = Superior (Cymba) concha • Digestive = around helix crus
Spine on antihelix • Upper limb on scaphoid fossa • Lower limb on upper antihelix crus • Triangular fossa = Chinese: Reproductive & Shenmen; French: Lower limb
Lobe: Cranial area/face/sensory on lobe • Internal organs in concha • Spine on antihelix • Upper limb on scaphoid fossa • Lower limb on upper antihelix crus • Triangular fossa = Chinese: Reproductive & Shenmen; French: Lower limb
NADA Protocol • AKA: 5-Needle Protocol, 5NP • Most common auricular protocol used today • Use for addictions, trauma, pain, etc
Shen Men: Slightly superior and anterior to the tip of the triangular fossa. • Sympathetic-Autonomic point: Junction of the internal helix and the inferior antihelix crus. It is covered by the fold of the helix. • Liver: Junction of the concha ridge/helix crus with the posterior concha wall (just anterior to antihelix). Some maps place it slightly superior to the concha ridge.
Kidney: In superior concha, near concha wall, directly below Shen Men. • Lung 2: In lower part of inferior concha, just below deepest part of concha (Heart point).
Diagnosis • Ear probe - look for painful points • Electronic point finder - low skin resistance • Visual inspection - Discoloration
Treatment • Filiform needles • Press tacks or intradermals • Seeds • Bleeding • Ear massage • Electric stim • Cold laser
Needling • Disinfect skin with alcohol • Use 15mm, 7mm or press tack • Filiform needle retain 20-40 minutes • Check for bleeding on removal of needle
Precautions • Do not needle if external ear is infected or inflamed • Contraindicated for pregnancy with history of miscarriage; caution otherwise • Caution weak constitution • Do not leave tacks or seeds more than 1 week
Scalp Acupuncture • Several different systems: Jiao, Zhu, Yamamoto (YNSA), etc • Jiao system most common
Motor Area • Location: Locate the upper point 0.5 cm posterior to the mid-point of the anterior-posterior midline. • Then locate the lower point at the intersection of the eyebrow-occiput line with the anterior temporal hairline. • The line connecting the upper and lower points is the motor area. • This line is divided into five equal portions.
Motor Area • Lower limb and trunk areaLocation: Upper 1/5 of the motor area. Indications: Contralateral paralysis of the lower limbs. • Upper limb areaLocation: Middle 2/5 of the motor area. Indications: Paralysis of the upper limbs. • Facial areaLocation: Lower 2/5 of the motor area. Indications: Facial paralysis, motor aphasia, salivation, impaired speech, and dysphonia.
Sensory Area • Location: The line parallel to and 1.5 cm posterior to the motor area. Divide this line into five equal portions. • Lower limb, head, and trunk areaLocation: Upper 1/5 of sensory area. Indications: Contralateral lumbar pain, leg pain, numbness, paresthesia, occipital headache, neck pain, tinnitus. • Upper limb areaLocation: Middle 2/5 of the sensory area. Indications: Upper limb pain, numbness, paresthesia. • Facial areaLocation: Lower 2/5 of the sensory area. Indications: Facial numbness, migraine, trigeminal neural- gia, toothache, temporomandibular arthritis.
Chorea & Tremor Control Area • Location: Parallel and 1.5 cm anterior to the motor area. Indications: Chorea, Parkinson’s disease. • Blood vessel dilation and constriction area • Location: Parallel and 1.5 cm anterior to the chorea and tremor control area. Indications: Superficial edema, hypertension.
Vertigo and hearing area • Location: A horizontal line 1.5 cm above the ear apex; 2 cm anterior and 2 cm posterior (total 4.0 cm length). Indications: Tinnitus, vertigo, diminished hearing, Meniere’s syndrome. • Speech 3 • Location: A horizontal line starting at the midpoint of the Vertigo and Hearing Area and running posteriorly 4.0 cm in length. Indications: Sensory aphasia.
Speech 2 • Location: A vertical line 2.0 cm posterior and inferior to the parietal tubercle 3.0 cm in length. Indications: Nominal aphasia. • Voluntary Movement / Usage area • Location: At the parietal tubercle origin, three lines run inferiorly, anteriorly, and posteriorly 3.0 cm each with a 40° angle between each of the lines. Indications: Apraxia.
Foot Motor and Sensory Area • Location: Two lines 1.0 cm lateral to the midpoint of the anterior-posterior midline 3.0 cm in length posterior and parallel to the midline. • Indications: Contralateral lower limb pain, numbness, paralysis, acute lumbar sprain, nocturia, and uterine prolapse.
Vision area • Location: Two lines 1.0 cm lateral to the midpoint of the external occipital protuberance, parallel to the anterior-posterior midline, 4.0 cm in length extending superiorly. Indications: Visual disturbances, cortical blindness. • Balance area • Location: Two lines 3.5 cm lateral to the midpoint of the external occipital protuberance, parallel to the anterior-posterior midline, 4.0 cm in length extending inferiorly. Indications: Loss of balance due to cerebellar disorders, dizziness.
Stomach area • Location: Beginning at the hairline directly superior to the pupil of the eye, parallel with the anterior-posterior midline, 2.0 cm in length bilaterally extending posteriorly. Indications: Stomach / epigastric pain. • Thoracic cavity • Location: Beginning 2.0 cm below the hairline, midway between and parallel to the stomach area and the anterior- posterior midline, 4.0 cm in length bilaterally extending superiorly. Indications: Chest pain, palpitations, coronary heart disease, asthma, and hiccups.
Reproduction area • Location: Beginning at the hairline, a line 2.0 cm in length from the frontal angle extending posteriorly and parallel to the anterior-posterior midline. Indications: Functional uterine bleeding, pelvic inflammation, leukorrhea, and uterine prolapse.
Liver and Gallbladder Area • Location: Beginning at the hairline, a line 2.0 cm in length from the stomach area extending inferiorly. Indications: Upper right quadrant abdominal pain, chronic hepatitis, abdominal pain due to liver and gallbladder disease. • Intestine Area • Location: Beginning at the hairline, a line 2.0 cm in length from the reproduction area extending inferiorly. Indications: Lower abdominal pain.
Needle Technique • Clean insertion site with alcohol • Use 1-2 cun filiform needles, 28-32 gauge • Insert 30• angle, thread into aponeurosis • Twirling manipulation, up to 200x/minute • Manipulate 2-3 minutes, rest 5-10 minutes and repeat 2-3 times; or use high frequency e-stim (200-300 hz)
Precautions • Seated or lying position; watch for fainting • Not advisable for weak patients, high fever, local inflammation, heart failure • Contraindicated if open head wounds or intracranial bleeding; wait until bleeding has stopped and patient is stable