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Precise location of Chinese scalp acupuncture areas requires identification of two

imaginary lines on the head. The anterior-posterior line runs along the centerline of the
head. The midpoint of the skull is located at the midpoint between the occipital
protuberance and the glabella, midway between the eyebrows. The second line, the
horizontal line, runs from the highest point of the eyebrow to the occipital protuberance.
Where this line intersects the anterior hairline defines the lower point of the motor area
(Fig. 19-3). In patients without a definite hairline, an alternative method for locating this
point is to draw a vertical line up from acupuncture point ST-7 until it intersects the line
from the brow to the occipital.

Figure 19-3 Lower point of the motor area.

(Courtesy Jason Jishun Hao.)

Motor Area Location

The motor area is located on the projective area of the scalp corresponding to the
precentral gyrus of the frontal lobe. The motor area is located in a strip beginning at the
midline at a point 0.5 cm posterior to the previously located midpoint of the head, along
the anterior-posterior line.4 The motor area runs from this point obliquely down to the
point where the eyebrow-occipital line intersects the anterior hairline (Fig. 19-4). The
line of the motor area determines the angle and location of several other areas, such as
the sensory area and chorea and tremor area.
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Figure 19-4 The motor area runs from this point obliquely down to the point where the
eyebrow-occipital line intersects the anterior hairline.

(Courtesy Jason Jishun Hao.)

The motor area of the cerebral cortex controls and adjusts intersectional body
movements. One side of the cerebral cortex controls contralateral muscles of the body in
the level below the neck. One exception is that most head and face muscles are bilateral.
The size of the motor gyrus of the cerebral cortex is associated with complexity and
accuracy of body movement. A larger representative area equates to greater complexity
and accuracy. The motor gyrus is depicted as an upside-down human body image. For
example, the upper part of the gyrus controls the lower limbs, whereas the middle part
of the gyrus controls upper limbs, and the lower parts control head and face movement.

The motor area is divided into three regions according to the homunculus projection.5 In
order to correctly locate those three regions, the whole motor area is first equally
divided into fifths. Then three regions are measured as Upper one-fifth region, Middle
two-fifths region, and Lower two-fifths region. The Upper one-fifth region is used to
treat contralateral movement dysfunction of the lower extremity, trunk, spinal cord, and
neck. The Middle two-fifths region is used to treat contralateral movement dysfunction
of the upper extremity. The Lower two-fifths region is used to treat bilateral movement
dysfunction of the face and head. These areas are used to affect the contralateral side of
the body. The direction of needling is usually from the upper part of the area downward,
penetrating to the entire area.
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Motor Area Indications

Indications to apply needles in the motor area are: paralysis or weakness in the face,
trunk, or limbs caused by stroke; multiple sclerosis; traumatic paraplegia; acute
myelitis; progressive myotrophy; neuritis; poliomyelitis; post-polio syndrome; periodic
paralysis; hysterical paralysis; Bell’s palsy; spinal cord injury; traumatic brain injury;
and brain surgery.

Among the disorders mentioned earlier, the most common problems are generally
paralysis due to stroke, multiple sclerosis, and traumatic injury. When treating a
thrombosis and embolism stroke, scalp acupuncture treatment should begin as soon as
possible. When treating a hemorrhagic stroke, scalp acupuncture treatment should not
be performed until the patient’s condition is stable, typically at least 1 month after the
stroke. Although stroke can be treated at any stage, the greatest response to treatment
will be for strokes occurring less than a year prior to scalp acupuncture. The longer the
duration of the impairment, the more gradual the improvement will be. With long-term
cases of impairment, expectations need to be realistic, although some patients will
occasionally surprise practitioners. Improvement is rare for patients with a long history
of paralysis that has led to muscular atrophy, rigid joints, and inflexibility.

When treating chronic progressive diseases like multiple sclerosis and Parkinson’s, the
results from treatment are sometimes temporary. Results may last for hours, days,
weeks, or months, but ongoing follow-up treatments will be necessary. However, when
treating paralysis from either stroke or trauma, the improvements of movement are often
permanent.

Although each part of the cerebral cortex has its own functions, it is relative to our
understanding of brain functions. When one area is impaired, the impaired area can
recover to a limited extent. In addition, by employing proper stimulation, other areas
can compensate for the impaired area. This may be the answer to explaining the
mechanism of scalp acupuncture in treating cerebral cortex impairment. Generally
speaking, paralyzed extremities are targeted by treating the opposite site of the motor
area in the scalp. For instance, if a patient has paralysis of the right leg and foot, needles
should be inserted into the patient’s left side of the scalp motor area. However, for
patients undergoing brain surgery or with an injury where part of the brain was
removed, needling should be on the same side of the scalp as the side of the paralyzed
limb.

For treating motor dysfunction, place the needles and rotate them at 200 times per
minute for 2 to 3 minutes every 10 minutes for a total of 30 to 60 minutes. More
difficult cases require longer treatment times. For the best results, the patient should feel
something in the reference area: tingling, movement, twitching, heat, cold, and so on.
After stimulating the needles, begin passive and active movement of the affected limbs.
It is helpful to have the patient walk, with or without assistance as indicated, between
stimulations. Initially, the treatment should be twice a week until major improvements
are achieved, then once weekly, then every 2 weeks, and then spaced out as indicated by
the patient’s condition.

https://clinicalgate.com/the-treatment-of-pain-through-chinese-scalp-acupuncture/
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Scalp acupuncture was first introduced by a group of medical workers in Chi San
People’s Hospital, Shensi Province, China, in the early 1970s. It represents a correlation
between modern theories of neuroanatomy and traditional Chinese acupuncture and,
although only a few years old, it has already been shown effective in the treatment of
many clinical conditions, particularly those of the central nervous system.

Traditional Chinese theory postulates that connections exist between specific areas of
the scalp and of the brain. Many of these connected areas have been found effective
therapeutically when used according to accepted acupuncture techniques. They include
motor and sensory areas, the chorea-tremor control area, speech and visual areas, and so
on.

Figure 44

Selection of Areas

There are two basic planes to consider when identifying scalp acupuncture areas (Fig.
44): (1) the anteroposterior plane, which connects the midpoint between the eyebrows
and the lower edge of the occipital protuberance, and (2) the eyebrow-occipital plane,
which connects the upper edge of the mid-point of the eyebrow and the lateral aspect of
the tip of the occipital protuberance, bilaterally.

Speech area no. 2 is located posterior and inferior to extreme of the parietal tuberosity
and parallel to the anteroposterior plane. It is 3 cm in length (Fig. 45).
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Figure 45

Stimulation areas, posterior view.

Figure 46
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Figure 47

Stimulation areas, vertical view

Indications: for aphasia

Visual Area

The visual area is located 1 cm lateral and parallel to the antero-posterior plane at the
level of the occipital protuberance. It is 4 cm in length (Fig. 45).

Indications: for cortical visual disturbances

Equilibrium Area

The equilibrium area is located 3.5 cm lateral to the anteroposterior plane immediately
below the level of the external occipital protuberance and directly overlying the
cerebellum. It is 4 cm in length (Fig. 46).

Indications: for disturbances of equilibrium caused by disorders of the cerebellum

Motor Area

The motor area is located 0.5 cm behind the midpoint of the anteroposterior plane and
from there down to the junction point between the eyebrow-occipital plane and the
frontal edge of the hairline at the temporal angle (Fig. 46).

Indications:

The upper one-fifth of the motor area-for paralysis of the lower extremities on the
opposite side
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The middle two-fifths of the motor area-for paralysis of the upper extremities on the
opposite side

The lower two-fifths of the motor area (also called speech area no. 2) for central facial
paralysis, motor aphasia, ptyalorrhea, and disorders of the vocal cords

Sensory Area

The sensory area is located 1.4 cm posterior to and parallel with the motor area (Fig.
46).

Indications:

The upper one-fifth of the sensory area-for pain, numbness, and abnormal sensation in
the lower extremities on the opposite side; neck pain; occipital headache; and tinnitus

The middle two-fifths of the sensory area-for pain, numbness, tingling, and other
abnormal sensations in the upper extremities on the opposite side

The lower two-fifths of the sensory area-for migraine headache, facial paralysis, and
pain associated with arthritis of the temporomandibular joint

Chorea-Tremor Control Area

The chorea-tremor control area is located 1.5 cm anterior to and parallel with the motor
area (Fig. 46).

Indications: For Sydenham’s chorea and Parkinsonism Treat the opposite side for
contralateral disorders, and both sides for bilateral involvement.

Auditory Area

The auditory area is located 1.5 cm directly above the tip of the ear, with a width of 4
cm on the horizontal plane (Fig. 46).

Indications: For tinnitus, dizziness, and Meniere’s disease

Speech Area No. 3

Speech area no. 3 is located on the horizontal plane that extends posteriorly 4 cm from
the midpoint of the auditory area (Fig. 46).

Indications: For sensory aphasia Motor Sensory Area for the Foot The motor sensory
area for the foot is located 1 cm bilateral and parallel to the midpoint of the
anteroposterior plane. It is 3 cm in length (Fig. 45; also, see Fig. 47).

Stomach Area
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The stomach area is located in the frontal region and runs upward from the hairline. It is
on a line directly vertical to the pupil of the eye and parallel to the anteroposterior plane.
It is 2 cm in length (Fig. 48).

Indications: For upper abdominal pain

Thoracic Area

The thoracic area is located between the stomach area and the anteroposterior plane. It
is 4 cm in length, with half (2 cm) being above the hairline, and half (2 cm) below the
hairline (Fig. 48).

Indications: For bronchial asthma, chest discomfort, and tachycardia

Genital Area This runs upward from the frontal angle at the hairline and is parallel to
the anteroposterior plane. It is 2 cm in length (Fig. 49).

Indications: For menstrual disorders

Technique Preparation

Needles: 2.5-3.0 inches long, 28-30 gauge

Position: Patient may be prone, supine, or lateral.

Stimulation After diagnosis has been made and areas for stimulation have been carefully
identified, sterilize the skin routinely and insert needles obliquely into the skin or
muscular layer until Teh Chi is obtained and the desired depth is reached (Fig. 49). Use
electric or manual stimulation and deliver 200 pulses/min for 2-3 min, then leave
needles in place for 15-20 min. Patients should be treated daily or every other day for a
2-week period, then be allowed to rest for 1 week before a second course is given.
When the needles are inserted, patients usually experience a transitory numbness
accompanied by sensations of warmth, heat, or twitching; these may last for several
minutes before they disappear.
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Figure 48

Stimulation areas, frontal view

Since scalp acupuncture is such a new procedure, further investigations are required to
determine the best techniques to be used and a continuing evaluation of results is also
required.