In the neurological field, headaches, migraines and neuralgia are the common painful conditions treated with acupuncture. Strokes and their sequelae are another major indication for acupuncture. Early treatment of paresis after stroke has proved highly effective.
Because improvement in the effects of stroke also occurs naturally, there has been some doubt about the contribution of acupuncture. In recent years, however, a number of controlled clinical evaluations have been undertaken in stroke patients. For example, in randomized controlled studies, acupuncture treatment of hemiplegia due to cerebral infarction gave better results than conventional medication (88-93) and physiotherapy (94, 95). There were also beneficial effects when acupuncture was used as a complement to rehabilitation (96-98).
In one study, patients with ischaemic cerebrovascular disease treated with acupuncture were compared with patients treated with conventional drugs. Nerve function, as evaluated by electroencephalographic map and somatosensory evoked potential, showed a much more marked improvement in the patients treated with acupuncture (89). This has been further confirmed by experimental studies. In the laboratory, a rat model of reversible middle cerebral artery occlusion was used. The somatosensory evoked potential recorded before and after the occlusion showed that electric acupuncture markedly promoted the recovery of the amplitude of the P1-N1 wave (to 58.6% in the electric acupuncture group in contrast to 25.5% in the control group after 7 days) (93). In addition, recent clinical studies suggest that the effectiveness of acupuncture therapy can be further promoted by using temporal acupuncture (99, 100).
Comparative studies have shown acupuncture treatments to be as effective for treating hemiplegia due to cerebral haemorrhage as for that due to cerebral infarction. Since early treatment with physiotherapy is unsatisfactory, it is advisable to use acupuncture as the primary treatment. Even in hemiplegia of long duration, remarkable improvements can often be achieved. Hemiplegia due to other causes, such as brain surgery, can also be improved by acupuncture (101). Aphasia caused by acute cerebrovascular disorders can also be treated with acupuncture (102).
Although acupuncture is effective for many painful conditions, there are only a few reports on post-herpetic neuralgia. Two of them were based on randomized clinical trials and provided completely opposite results (103, 104). Evaluation of acupuncture in the treatment of this painful condition therefore awaits further study.
Peripheral nervous disorders are often treated with acupuncture. For example, good effects for Bell’s palsy have been reported in randomized controlled trials (105, 106). Facial spasm is another peripheral nervous disorder for which acupuncture treatment may be indicated. For this condition it has been shown that wrist-ankle acupuncture is significantly better than traditional body acupuncture (107).
Coma is a serious condition that can hardly be cured by acupuncture alone, but in a comparative study of two groups of patients with similar levels of coma, a significantly greater number of patients in the acupuncture group had a 50% or greater neurological recovery than those in the control group. This suggests that it is reasonable to incorporate acupuncture along with other therapeutic and supportive measures in the treatment of the comatose patient (108).
Insomnia can also be treated successfully with acupuncture. In randomized control trials, both auricular acupressure and auricular acupuncture had a hypnotic effect (109, 110).