A Case Report of a Patient with Delayed Recovery from Peripheral Facial Palsy Treated with <i>Gami-Soyo-san</i> (加味逍遙散) and Facial Acupuncture

Introduction: Peripheral facial palsy with delayed recovery beyond 3 months is associated with reduced rates of complete spontaneous recovery, particularly in older adults with metabolic comorbidities. This report presents a case of integrative Korean medicine treatment for persistent peripheral facial palsy with delayed recovery, in which long-standing suspected Frey’s syndrome also improved.Case Presentation: An 81-year-old woman with diabetes and dyslipidemia presented with right peripheral facial palsy of 4 months’ duration. She also reported gustatory sweating suggestive of Frey’s syndrome that had persisted for approximately 19 years following parotidectomy in 2005. The patient received 56 sessions of manual acupuncture combined with oral <i>Gami-Soyo-san</i> (加味逍遙散) extract granules over 5 months at a public health center branch. The House-Brackmann grade improved from V to II, and the Yanagihara score increased from 17 to 26. The suspected Frey’s syndrome symptoms subjectively improved after approximately 4 weeks, with severity decreasing from 10 to below 5 on a self-rated 10-point scale. Mild subjective synkinesis appeared at week 9 and was considered a natural sequela of aberrant reinnervation. No adverse events were observed. At telephone follow-up 3 months after treatment completion, the clinical improvement was reported to be maintained.Discussion: This case suggests that integrative Korean medicine treatment may be associated with a favorable clinical course in persistent peripheral facial palsy with delayed recovery in a primary care setting, with concurrent improvement in long-standing suspected Frey’s syndrome as a secondary finding. Further case accumulation and prospective studies incorporating objective measures are warranted.