Auricular & Scalp Acupuncture Review
Lecturer: M.K. Sastry
Auricular
Anatomy & Somatatopic
Representation
• Modern Auriculotherapy founded by Paul
Nogier in 1950‘s France
• Also developed in 1960’s China
• Some differences in point location but
overall very similar
• Fetal / “Upside-down man” representation
• Lobe: Face & sensory
• Antitragus: Cranial & brain
• Internal organs in concha:
• Thorax = Inferior (Cavum) concha
• Abdomen = Superior (Cymba) concha
• Digestive = around helix crus
• Spine on antihelix
• Upper limb on scaphoid fossa
• Lower limb on upper antihelix crus
• Triangular fossa = Chinese: Reproductive &
Shenmen; French: Lower limb
• Lobe: Cranial area/face/sensory on lobe
• Internal organs in concha
• Spine on antihelix
• Upper limb on scaphoid fossa
• Lower limb on upper antihelix crus
• Triangular fossa = Chinese: Reproductive &
Shenmen; French: Lower limb
NADA Protocol
• AKA: 5-Needle Protocol, 5NP
• Most common auricular protocol used today
• Use for addictions, trauma, pain, etc
• Shen Men: Slightly superior and anterior to
the tip of the triangular fossa.
• Sympathetic-Autonomic point: Junction of
the internal helix and the inferior antihelix
crus. It is covered by the fold of the helix.
• Liver: Junction of the concha ridge/helix crus
with the posterior concha wall (just anterior
to antihelix). Some maps place it slightly
superior to the concha ridge.
• Kidney: In superior concha, near concha
wall, directly below Shen Men.
• Lung 2: In lower part of inferior concha, just
below deepest part of concha (Heart point).
Diagnosis
• Ear probe - look for painful points
• Electronic point finder - low skin resistance
• Visual inspection - Discoloration
Treatment
• Filiform needles
• Press tacks or intradermals
• Seeds
• Bleeding
• Ear massage
• Electric stim
• Cold laser
Needling
• Disinfect skin with alcohol
• Use 15mm, 7mm or press tack
• Filiform needle retain 20-40 minutes
• Check for bleeding on removal of needle
Precautions
• Do not needle if external ear is infected or
inflamed
• Contraindicated for pregnancy with history
of miscarriage; caution otherwise
• Caution weak constitution
• Do not leave tacks or seeds more than 1
week
Scalp Acupuncture
Scalp Acupuncture
• Several different systems: Jiao, Zhu,
Yamamoto (YNSA), etc
• Jiao system most common
Motor Area
• Location: Locate the upper point 0.5 cm posterior to the
mid-point of the anterior-posterior midline.
• Then locate the lower point at the intersection of the
eyebrow-occiput line with the anterior temporal hairline.
• The line connecting the upper and lower points is the
motor area.
• This line is divided into five equal portions.
Motor Area
• Lower limb and trunk area Location: Upper 1/5 of the
motor area. Indications: Contralateral paralysis of the lower
limbs.
• Upper limb area Location: Middle 2/5 of the motor area.
Indications: Paralysis of the upper limbs.
• Facial area Location: Lower 2/5 of the motor area.
Indications: Facial paralysis, motor aphasia, salivation,
impaired speech, and dysphonia.
Sensory Area
• Location: The line parallel to and 1.5 cm posterior to the
motor area. Divide this line into five equal portions.
• Lower limb, head, and trunk area Location: Upper 1/5 of
sensory area. Indications: Contralateral lumbar pain, leg
pain, numbness, paresthesia, occipital headache, neck pain,
tinnitus.
• Upper limb area Location: Middle 2/5 of the sensory area.
Indications: Upper limb pain, numbness, paresthesia.
• Facial area Location: Lower 2/5 of the sensory area.
Indications: Facial numbness, migraine, trigeminal neural-
gia, toothache, temporomandibular arthritis.
• Chorea & Tremor Control Area
• Location: Parallel and 1.5 cm anterior to the motor area.
Indications: Chorea, Parkinson’s disease.
• Blood vessel dilation and constriction area
• Location: Parallel and 1.5 cm anterior to the chorea and
tremor control area. Indications: Superficial edema,
hypertension.
• Vertigo and hearing area
• Location: A horizontal line 1.5 cm above the ear apex; 2 cm
anterior and 2 cm posterior (total 4.0 cm length).
Indications: Tinnitus, vertigo, diminished hearing,
Meniere’s syndrome.
• Speech 3
• Location: A horizontal line starting at the midpoint of the
Vertigo and Hearing Area and running posteriorly 4.0 cm in
length. Indications: Sensory aphasia.
• Speech 2
• Location: A vertical line 2.0 cm posterior and inferior to the
parietal tubercle 3.0 cm in length. Indications: Nominal
aphasia.
• Voluntary Movement / Usage area
• Location: At the parietal tubercle origin, three lines run
inferiorly, anteriorly, and posteriorly 3.0 cm each with a 40°
angle between each of the lines. Indications: Apraxia.
Foot Motor and Sensory Area
• Location: Two lines 1.0 cm lateral to the midpoint of the
anterior-posterior midline 3.0 cm in length posterior and
parallel to the midline.
• Indications: Contralateral lower limb pain, numbness,
paralysis, acute lumbar sprain, nocturia, and uterine
prolapse.
• Vision area
• Location: Two lines 1.0 cm lateral to the midpoint of the
external occipital protuberance, parallel to the anterior-
posterior midline, 4.0 cm in length extending superiorly.
Indications: Visual disturbances, cortical blindness.
• Balance area
• Location: Two lines 3.5 cm lateral to the midpoint of the
external occipital protuberance, parallel to the anterior-
posterior midline, 4.0 cm in length extending inferiorly.
Indications: Loss of balance due to cerebellar disorders,
dizziness.
• Stomach area
• Location: Beginning at the hairline directly superior to the
pupil of the eye, parallel with the anterior-posterior
midline, 2.0 cm in length bilaterally extending posteriorly.
Indications: Stomach / epigastric pain.
• Thoracic cavity
• Location: Beginning 2.0 cm below the hairline, midway
between and parallel to the stomach area and the anterior-
posterior midline, 4.0 cm in length bilaterally extending
superiorly. Indications: Chest pain, palpitations, coronary
heart disease, asthma, and hiccups.
• Reproduction area
• Location: Beginning at the hairline, a line 2.0 cm in length
from the frontal angle extending posteriorly and parallel to
the anterior-posterior midline. Indications: Functional
uterine bleeding, pelvic inflammation, leukorrhea, and
uterine prolapse.
• Liver and Gallbladder Area
• Location: Beginning at the hairline, a line 2.0 cm in length
from the stomach area extending inferiorly. Indications:
Upper right quadrant abdominal pain, chronic hepatitis,
abdominal pain due to liver and gallbladder disease.
• Intestine Area
• Location: Beginning at the hairline, a line 2.0 cm in length
from the reproduction area extending inferiorly.
Indications: Lower abdominal pain.
Needle Technique
• Clean insertion site with alcohol
• Use 1-2 cun filiform needles, 28-32 gauge
• Insert 30• angle, thread into aponeurosis
• Twirling manipulation, up to 200x/minute
• Manipulate 2-3 minutes, rest 5-10 minutes
and repeat 2-3 times; or use high frequency
e-stim (200-300 hz)
Precautions
• Seated or lying position; watch for fainting
• Not advisable for weak patients, high fever,
local inflammation, heart failure
• Contraindicated if open head wounds or
intracranial bleeding; wait until bleeding has
stopped and patient is stable