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

Dr. Li Wei, DACM

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

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Wind-Heat Attacking the Collaterals is a pattern in acute Bell’s palsy, characterized by facial nerve inflammation (HSV-1 reactivation), sudden facial paralysis, facial heat pain, fever, and sore throat. The core pathogenesis is invasion of Wind-Heat pathogens into the facial collaterals, causing viral-induced neuroinflammation, nerve damage, and facial paralysis.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sudden facial paralysis, facial heat pain, ear pain, fever |

| Associated Symptoms | Sore throat, thirst, red eyes, irritability |

| Tongue and Pulse | Red tongue with thin yellow coating, floating and rapid pulse |

| Pathogenesis | Wind-Heat pathogens invading the facial collaterals |

| Etiology | Viral infection (HSV-1), upper respiratory infection, Wind-Heat invasion |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

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

| Quchi (LI11) | Lateral end of the elbow crease | Clears Heat and detoxifies |

| 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 |

| 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, use gentle technique. May combine with Dazhui pricking to enhance Heat clearing.

Herbal Formula

Base Formula: Qian Zheng San (牵正散) + Yin Qiao San (银翘散)

Composition:

White Aconite (Bai Fu Zi), Bombyx Batryticatus (Jiang Can), Scorpion (Quan Xie), Lonicera (Jin Yin Hua), Forsythia (Lian Qiao), Mint (Bo He), Isatis (Ban Lan Gen), Licorice (Gan Cao)

Action: Disperses Wind-Heat, clears toxins, unblocks collaterals, and corrects facial deviation.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe facial heat pain | Add Shi Gao, Zhi Mu to clear Heat and generate fluids |

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

| Sore throat | Add Ban Lan Gen, Xuan Shen to clear Heat and relieve sore throat |

| Headache | Add Ju Hua, Man Jing Zi to disperse Wind and clear Heat |

| Herpetic lesions | Add Long Dan Cao, Ze Xie to clear Damp-Heat |

Western Mechanism Reference

Facial nerve inflammation following HSV-1 reactivation, with viral-induced neuroinflammation and nerve damage. Wind-Heat Attacking the Collaterals corresponds to Bell’s palsy associated with HSV-1 reactivation, where viral replication and neuroinflammation contribute to facial nerve damage.

References

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

  2. Zang-Fu Pattern Differentiation: Wind-Heat → 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.

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM neurology.