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Bell's palsy or idiopathic facial palsy is the most common disorder affecting the facial nerves and results in weakness or paralysis on one side of the face. The paralysis causes distortion of the face and interferes with normal functions, such as closing the eye and eating. It is thought to be caused by inflammation of the facial nerve.

According to Traditional Chinese Medicine, facial paralysis is known as 'deviated mouth'. It was attributed to 'wind' by past dynasties. 'Qi' refers to the vital substances comprising the human body and the physiological functions of viscera and bowels, channels and collaterals. It maintains life activities and reflects the resistance of the human body. Deficiency of 'qi' allows the invasion of exogenous pathogenic wind. Acupuncture is part of Traditional Chinese Medicine and dates back thousands of years. It involves inserting fine needles into specific points on the skin or applying various other techniques to the acupuncture points to bring about healing. In Bell's palsy, acupuncture treatment might have numerous beneficial effects. This review aimed to review systematically all randomised controlled trials and controlled clinical trials, which examined the effectiveness of acupuncture for Bell's palsy. Six studies including a total of 537 participants met the inclusion criteria. Five studies used acupuncture while the other used acupuncture combined with drugs. No trials reported on the outcomes specified for this review. Harmful side effects were not reported in any of the trials. Flaws in study design or reporting (particularly whether the process of assigning people to different groups was hidden and also substantial losses to follow-up), and clinical differences between trials prevented conclusions about the efficacy of acupuncture. The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.

Acupuncture for acute stroke

There is no clear evidence of benefit from acupuncture in acute stroke. In China, acupuncture is used to treat many acute and chronic conditions, including stroke. We reviewed evidence from randomised controlled trials investigating acupuncture in patients with acute stroke, to determine whether acupuncture was safe, and whether it could reduce the number of patients who died, or were left needing help with everyday activities. The review showed no clear effect of acupuncture on either outcome. Serious adverse effects were uncommon, and occurred in about one in every hundred patients treated. Results from much larger randomised trials are needed to assess accurately the benefits and harms of acupuncture in acute stroke.

Acupuncture for dysphagia in acute stroke

Better designed clinical trials are needed to prove whether acupuncture is effective for treating swallowing difficulties in patients with stroke. Patients who have swallowing difficulties (dysphagia) as a result of their stroke are less likely to survive and be free of disability than stroke patients who can swallow normally. Acupuncture is commonly used to treat this complication in traditional Chinese medicine practice. We systematically reviewed currently available evidence for the use of acupuncture in treating swallowing difficulties after acute stroke. Only one small randomised controlled trial was identified, involving 66 participants, which did not provide clear evidence of benefit from adding acupuncture to standard Western medical treatment. Considering the small sample size and methodological imperfections, there is insufficient evidence to determine the effectiveness of acupuncture. More research is needed.

Acupuncture for stroke rehabilitation

There is no clear evidence of the effects of acupuncture on stroke rehabilitation. Acupuncture has biological effects that might improve recovery from stroke or facilitate rehabilitation. This review looked for randomised trials comparing acupuncture with control in patients who had a stroke more than one month previously. Five trials were identified but all the trials were of poor quality and no definite conclusions could be drawn about the effects of acupuncture in such patients. More large, high quality randomised trials are needed.