A 3-year-old boy presenting with acute facial nerve paralysis, hip pain, and structural spinal deviation caused by excessive screen time was successfully managed using a combination of spinal adjustment, acupuncture, and Wind-dispersing herbal therapy.

Case ID: CHC-0054

Case Summary

This case describes a 3-year-old boy who, following a recent cold, suddenly developed facial paralysis (“crooked mouth”) and acute right hip/leg pain that prevented him from walking. The patient had a notable history of prolonged phone usage with a bowed head since age 2. The original report documented a conventional diagnosis of pediatric scoliosis with facial nerve paralysis (and suspected transient synovitis of the hip). The TCM assessment was Wry Mouth Wind (Wai Zui Feng) and Spinal Deviation driven by Wind Pathogens Striking the Collaterals and Wind-Damp-Stasis. He was managed through a highly integrative approach combining “Zhao’s Balanced Spinal Adjustment,” localized acupuncture, and a modified Xiaofeng San herbal decoction.

Patient Presentation

• Patient: 3-year-old male (Surname: Chen).
• Main Complaint: Acute right-sided facial paralysis, nasal congestion, and right hip/leg pain preventing him from walking.
• History: The patient sought initial consultation on February 3, 2022. One month prior, he caught a cold with a runny nose and cough, which resolved after taking pediatric herbal granules. Shortly after, his parents noticed a mild “crooked mouth” but dismissed it as the child making faces. By the morning of the consultation, the facial paralysis was obvious. Furthermore, he woke up with severe right hip and leg pain, refusing to get out of bed, stand, or walk. Notably, since age 2, the child had a habit of playing on a mobile phone for long periods with his head bowed.

Examination and Diagnosis

• Physical Exam: Right facial and lip swelling with a drooping mouth, loss of facial expression, absent right forehead wrinkles, incomplete eye closure, excess tearing, and a shallow nasolabial fold. Mild cervical and thoracic scoliosis was observed, with palpable taut bands and tenderness in the paraspinal myofascia. His legs were of unequal length. The right hip “4” test (Patrick’s test) was positive, with pain upon flexion.
• Imaging & Labs: X-rays revealed an asymmetrical atlantoaxial (C1-C2) odontoid process with uneven joint spaces, and mild thoracic scoliosis. Blood work was normal.
• Conventional Diagnosis: 1. Pediatric scoliosis complicated by facial nerve paralysis; 2. Pediatric transient synovitis of the hip (suspected).
• TCM Tongue and Pulse: The tongue was pale red with a thin, white coating. The pulse was floating (脉浮).

TCM Assessment

The original practitioner interpreted the presentation as Wry Mouth Wind (Facial Paralysis) and Spinal Deviation driven by Wind Pathogens Striking the Collaterals and Wind-Damp-Stasis (歪嘴风，脊歪 – 风邪中络，风湿瘀阻).

According to the holistic principles of yin and yang Chinese Medicine the spine is the central pillar of the body’s structural and energetic network. The prolonged habit of looking down at a phone caused chronic strain and micro-misalignments in the child’s cervical and thoracic spine. When the child recently caught a cold, the external Wind pathogen invaded the body (“righteous Qi drawing in the pathogen”).

Because his cervical spine (neck) was already structurally compromised and tight, the Wind pathogen easily became trapped in the facial and spinal collaterals. This localized blockage cut off normal nerve and blood flow, resulting in the acute facial paralysis. Simultaneously, Wind-Dampness lodged in his structurally imbalanced lower body (hip joint), causing the acute leg pain and limping. The floating pulse confirmed the presence of the active external Wind pathogen.

Treatment Approach

The primary treatment principle was to support righteous Qi and dispel pathogenic factors, disperse Wind and unblock the collaterals (扶正祛邪，疏风通络). The strategy combined internal herbs to fight the viral/wind pathogen, acupuncture to stimulate the facial nerves, and targeted chiropractic adjustments to correct the underlying structural dysfunction.

Interventions and Herbal Formulas

• Zhao’s Balanced Spinal Adjustment (Manipulative Therapy): Administered once every 3 days. The practitioner utilized a specialized 6-step pediatric sequence including: gentle myofascial release of the neck and back; cervical traction and rotation to reset the C1-C2 joint space; targeted thumb pressing to correct thoracic and cervical subluxations; and a specialized rotational pelvic maneuver to balance the sacroiliac joint and resolve the hip pain.
• Acupuncture Therapy: Administered once every 3 days (20-minute retention).
  • Primary points: Fengchi (GB20), Taichong (LR3), Hegu (LI4), Zusanli (ST36).
  • Local facial points: Sibai (ST2), Xiaguan (ST7), Quanliao (SI18), Yingxiang (LI20), Dicang (ST4), Chengjiang (CV24), Jiache (ST6), Tinggong (SI19).
  • Distal points: Sanyinjiao (SP6).
• Internal Herbal Formula (February 3, 2022): A 14-herb decoction acting as a modified Xiaofeng San (Disperse Wind Powder).
  • Dispersing Wind and Dampness: Jing Jie Sui (3g), Qiang Huo (3g), Gui Zhi (5g), Fang Feng (5g), Huo Xiang (3g), and Cang Er Zi (5g) actively pushed the external Wind-Cold-Damp pathogens out of the head, face, and joints.
  • Unblocking Collaterals and Moving Blood: Chuan Xiong (3g) and Jiang Can (Silkworm, 3g) specialized in guiding the herbs to the head, treating the facial paralysis, and stopping the spasm.
  • Supporting Righteous Qi and Spleen: Huang Qi (6g), Dang Shen (6g), Fu Ling (6g), Bai Zhu (5g), and Jiang Hou Po (4g) warmed Yang, boosted Qi, and strengthened the Spleen to support the child’s internal immunity. Gan Cao (5g) harmonized the decoction.
  • Administration: 3 doses, 1 dose daily, taken in two divided doses.

Follow-Up

• Second Visit (February 7, 2022): After just 3 days, the child’s nasal congestion cleared, the facial paralysis improved, and he could confidently walk on the ground (hip pain resolved). Cang Er Zi was removed from the formula.
• Third Visit (February 11, 2022): The child was walking freely. The facial paralysis was significantly improved, and spinal palpation showed the muscles were much softer and straighter. Huo Xiang and Chuan Xiong were removed; Ge Gen (Pueraria, 6g – to further relax the neck) and Shan Yao (Chinese Yam, 6g) were added.
• Fourth & Fifth Visits (Feb 16 – Feb 23, 2022): The facial paralysis was basically cured. Internal herbs were stopped. Treatment continued with pediatric massage, spine adjustments, and acupuncture to consolidate the cure. The parents were strictly instructed to ensure a balanced diet, adequate sleep, restrict mobile phone screen time, and increase outdoor activities.

Why This Case Is Interesting (Clinical Reasoning)

The notable feature of this case is identifying a modern lifestyle habit (excessive screen time in a toddler) as the structural root of a classical neurological symptom (facial paralysis).

The practitioner emphasized that any compromise along the spine—whether from strain, subluxation, or inflammation—can trigger facial muscle paralysis when combined with an external pathogen like a cold virus. While standard medicine might treat this strictly with anti-inflammatories or antivirals for Bell’s Palsy and observe the hip (transient synovitis), the TCM approach recognized the mechanical link. By immediately correcting the C1-C2 misalignment and balancing the pelvis with manual therapy, alongside Wind-dispersing herbs and acupuncture, the practitioner achieved a rapid and total clinical recovery in a very young child.

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Source Original source: Traditional Chinese Medicine Bureau of Guangdong Province Original title: 【以案说医】招仕富：青少年脊柱侧弯合并面神经麻痹治疗验案 Practitioner: Professor Zhao Shifu (招仕富) Publication date: September 9, 2024 Original language: Chinese ChineseHerb.org version: English translation and editorial adaptation