Jia Nadia Guo M.D.,Acupuncture Specialist
(Medical Acupuncture Clinic,26 Summit Grove Avenue,Bryn Mawr,PA 19010,USA)

Introduction
This reportreviews how Electric Acupuncture (EA) has relieved frozen hands in a severe brain damagedindividual after ten years.Electric Acupuncture has been effective in reducing spasms andimproving motor function.

Case Report
E.B.,30years old,a young resident of Pennsylvania,has been paralyzed in brain injury for tenyears and suffered from rigidity in both hands as well muscle spasm in whole body with noway to relieve.
E.B.is reportedthe brain injured in February,1985.A heavy machine felt on E.B's head and he had multipleplaces damaged in his head.He was in a coma about a month after the injury and his limbssuffered total paralysis as well as lost his ability to walk,to talk.His hands closed inas a fists with entire body muscles spastic and rigidity.After the accident,he couldhardly do anything,he had to be tended by the nurses.
In the pastdecade,he has been given anti-spasm medications to relieve the pain of musclespasm.But,those treatments could only temporarily relieve his symptoms and make him verysleepy.He still had severe muscle spasms and pain when he woke up.He also tried differentkinds of treatments such as Surgery,Neuroblocker,Physical therapy,Massage with noeffect.For ten years,there is no way to help his hands open.Traditional western medicinetreatment has hardly changed his situation.He began acupuncture and visited MedicalAcupuncture Clinic in May 1995 by diagnosis:1).Brain Injury;2).CNS Paralysis;3)MuscleSpasm.

Observations/Findings
Patientsits on the wheel chair with disturbance of speech.
Neurologicalexamination revealed that the patient has multiple head lesion scars (1.Two scars at theright motor areas by 3cm × 1.5cm and 4.5cm × 3cm;2.One scar at the back of the head by 3cm × 2cm;3.One scar athis chin by 4.5cm × 1.5cm with his entire body spasm.Both of his hands and legs were rigid andparalysis.The frozen hands were closed in fists with poor circulaton.He could hardly openhis hands or straighten his fingers.The left hand was worse than the right.The hands inpoor coordinated movement.Muscle tone increased.Hyper flexibility at his joints.Right legalways spastic and tremors.
He was treated onthe Shou Shan Yang meridians by electric acupuncture.The enhanced treatment plan was 4times a week by eighteen months.It is generally believed that this patient's condition maynot be relieved by acupuncture after ten years.A miracle happend after acupuncturetreatments.His body muscle spasm seemed to have relieved and both hands are open andextended to about an angle 180 degrees.Everyone is surprised but happy for hisimprovements.Not only can his hands open,but they can perform tasks and change infunctions now.This is no less than a miracle.

Progress Report AfterAcupuncture
1. EAsignificantly improves the anatomy position recovery of the frozen hands.
1) Six Monthsafter Acupuncture:
i) The right handhas opened 100% and fingers straightened to an angle 180 degree.
ii) left handfingers straightened to an angle 90 degree.
2) EighteenMonths after Acupuncture:
(Conferred thepictures recording of December 1996)
i) Both of hishands have significantly improved over one year ago.
ii) The left handhas significantly improvement in fingers/hand straightened and opened about 90% in naturalposition with soft and flexible changes.
3) Three yearsAcupuncture:
E.B.follows upanother eighteen months EA on maintenance treatment by twice a week.
i) The letf handcontinues and changes to a maximal opening 95% and up.The fingers straightened about to anangle 180 degree (Picture June 1998).

Picture1 Acupuncture Relieves Ten Years ofFrozen Hands in Brain Injury

ii)Bothof hands are more close to the normal hand.They are soft and flexible.Those changes areslow,but the fists are miracle opened and recovery after they close in.
4) EA improvesshoulder abduction and decreases tremor in right leg.
2. EAsignificantly improves motor function recovery of the frozen hands.
With the revoveryof both hands anatomy position,the functions of the hands also gradually recover.He cannow do some simple tasks and the living activities such as bucking his belt,washing hishair,pulling his pants,feeding himself,painting,and coordinating his hands.
3. EAsignificantly changes the muscle spasm pain,anxiety and whole body situation.

Discuss
1. Tocompare the other treatments,EA is an high effect medical treatment in RehabilitationMedicine whether it be chronic or acute,simple of severe.It changes the physic conditionsby no side effects.
2. EA produces amaximal improvement in motor function in a long term treatment in the severe brain injury(three years).
3. The possiblemechanisms of Electronic Acupuncture on CNS Paralysis,Spasm.
Rigidity andConversion:
Decorticaterigidity due to lesions of the cerebral cortex.Mechanism of Decorticate rigidity is due to2 factors:increased general excitability of the motor neuron pool and increase in the rateof discharge in the gamma efferent neurons.EA balances the Central Nerve System andcontrols the muscle spasm which it involves in the following factors:
1) EA effects onMotor cortex area and promotes the motor function recovery.EA increases the circulation ofblood flow,metabolism and nutrition in motor cortex area and thalamus which directlybalances the energy in the brain and promotes the function recovery of the motor pathway:
2) EA effects onthe Inhibitor System of motor pathways and decrease general excitability of the motorneuron pool:
i) EA induces theneuron releasing inhibitory mediators or neurotransmitters (such as glycine,DA) and thisslows or stops the discharge of the motor neuron.
ii) Decrease therate of discharge in the gamma efferent neurons by hyperpolerization and threshold changeon th motor neuron:
The decreasedexcitability of the nerve cell is hyperpolerization through the inhibit system,it is alsoless excitable.
In spinalneurons,especially after repeated firing which induced by the electric acupucturepulses,this hyperpolerizatoin may be large and prolonged,because the threshold ofhyperpolerization of the spinal motor neuron and their excitability change the rate in thegamma efferent neurons to muscle spindles,it even stops discharge.Muscle rigid orconversion are inhibited by a decrease discharge in the motor neuron.
iii)The InhibitSystem are involved in these areas:
a) Cerebralcortex and limbic system;
b) Basal ganglia;
c) Cerebellum(Which produce IPSPs);
d) Pre synapticInhibition.
3) The MuscleSystem:EA induces the muscle contraction by electric pulses which it promote the atrophymuscle recovery as a exercise by dilation the blood vessels and increase the nutritionlocal.

Conclusion and outlook
^. EA significantly improves the anatomy position recovery and motor function recovery.
^. EA is an high effect medical treatment in Rehabilitation Medicine by no side effects.
^. The Possible Mechanisms of acupuncture treatment on CNS paralysis,Spasm,rigidity might act on the Inhibit System by hyperpolerization of the motor neuron pool.

Acupuncture Treatment Plan
1.Electric Acupuncture: Stronger stimulate.
(Machine:ElectronicAcupuncture Instrument ZYZ-20 GZI (Made in China) Continue Wave Frequency 15 ～ 20/sec.;Intensity 2 Timer 30minuets).
2. Goal:1)Paincontrol;2)Treatment for muscle spasm;3)Rehabilitation on CNS paralysis:
Hand i)Anatomyposition recovery;ii)Function recovery.
3. PrescriptionThe meridians of hands group acupuncture:Shou Shan Yang meridians.
1) The LargeIntestine Channel:Hegu (LI4),ShouSanLi (LI 10),QuChi(LI 11),WuLi(LI 13);
2)The SmallIntestine Channel (TaiYang):YangLao (SI 6);
3)The TripleEnergizer Channel (ShaoYang):Ye Men (TE 2);Zhi go (TE 6);Si Du (TE 9);
4)HandAcupuncture points:Neck (Hand 27):Between index and middle fingers;Throat (Hand29):Between Middle and ring fingers.
4. Enhancetreatment at the beginning:Four times a week one and half year;Maintenance treatment:afterAC one and half year:Two times a week.

Table 1 Acupuncture Relieves Ten Years of Frozen Hands in Brain Injury

Basic Information	1995 AC Early Stage	12/1996 AC Middle Stage (compare group)	6/1998 AC Late Stage (compare group)
1994 1 Before acupuncture,both hands were rigid with little function in his life (L+R)	06/1995 4 The rigid left hand (T)	12/1996 5 The left hand has significantly straightened and opened (T)	6/1998 6 The left hand has opened an angle close to about 180 degrees (T)
6/1998 2 The hands have significantly opened after acupuncture (L+R)	12/1995 7 The rigid left hand (R)	12/1996 8 The left hand is more flat than 12/1995 (R)
12/1996 3 Both hands are function recovery after acupuncture	12/1995 9 The rigid left hand (L)	12/1996 10 The left hand has opned an angle larger than 12/1995 (L)	6/1996 11 The left hand has opened an angle close to about 180 degrees (L+R)
		With the patient 12

Reference

(Executive Editor Deng Deling)