Bell's Palsy - Wind-Cold Attacking the Collaterals Pattern

Dr. Li Wei, DACM

Bell’s Palsy · Wind-Cold Attacking the Collaterals Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Wind-Cold Attacking the Collaterals is the core pattern in acute Bell’s palsy, characterized by facial nerve edema compressing the facial nerve, sudden facial paralysis, facial cold pain, ear pain, chills, and neck stiffness. The core pathogenesis is invasion of Wind-Cold pathogens into the facial Yangming collaterals, causing nerve edema, ischemia, and facial muscle paralysis.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sudden facial paralysis, facial cold pain, ear pain, inability to close the eye |

| Associated Symptoms | Chills, neck stiffness, facial numbness, drooling, tearing |

| Tongue and Pulse | Pale red tongue with thin white coating, floating and tense pulse |

| Pathogenesis | Wind-Cold pathogens invading the facial Yangming collaterals |

| Etiology | Cold exposure, sleeping with the face exposed, air conditioning drafts |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Fengchi (GB20) | Depression below the occipital bone, between the sternocleidomastoid and trapezius | Disperses Wind-Cold and clears the head |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Disperses Wind and unblocks collaterals |

| Dicang (ST4) | About 0.4 cun lateral to the corner of the mouth | Treats deviation of the mouth |

| Jiache (ST6) | In the depression on the lower border of the zygomatic arch, about 1 cun anterior to the angle of the mandible | Treats facial paralysis |

| Yangbai (GB14) | On the forehead, 1 cun above the midpoint of the eyebrow | Treats inability to close the eye |

| Yifeng (TE17) | Behind the ear, in the depression between the mastoid process and the mandible | Treats ear pain and facial paralysis |

Clinical Recommendation: Filament needle, even method; during the acute phase (first 7 days), use gentle technique. Electro-acupuncture may be added during the recovery phase.

Herbal Formula

Base Formula: Qian Zheng San (牵正散) + Ma Huang Fu Zi Xi Xin Tang (麻黄附子细辛汤)

Composition:

White Aconite (Bai Fu Zi), Bombyx Batryticatus (Jiang Can), Scorpion (Quan Xie), Ephedra (Ma Huang), Asarum (Xi Xin), Saposhnikovia (Fang Feng), Angelica Dahurica (Bai Zhi), Licorice (Gan Cao)

Action: Disperses Wind-Cold, unblocks collaterals, and corrects facial deviation.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe facial cold pain | Add Gui Zhi, Sheng Jiang to warm meridians |

| Ear pain | Add Chuan Xiong, Chai Hu to disperse Wind and stop pain |

| Tearing | Add Ju Hua, Sang Ye to disperse Wind and clear Heat |

| Neck stiffness | Add Ge Gen to relax sinews and unblock collaterals |

| Qi deficiency | Add Huang Qi, Dang Shen to supplement Qi and unblock collaterals |

Western Mechanism Reference

Facial nerve edema compressing the facial nerve, with increased intraneural pressure and nerve ischemia. Wind-Cold Attacking the Collaterals corresponds to acute Bell’s palsy, where viral reactivation (HSV-1) and nerve inflammation cause facial nerve edema, increased intraneural pressure, and nerve ischemia.

References

  1. Internal Medicine of TCM - Facial Paralysis with Wind-Cold Attacking Collaterals.

  2. Zang-Fu Pattern Differentiation: Wind-Cold → Clearing Pathway.

  3. WHO. (2023). Neurological health. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for facial nerve health.

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