Journal of Pain, Headache and Vertigo

POST HERPETIC NEURALGIA

Irsyah Dwi Rohmayanti, Shahdevi Nandar Kurniawan — Sun, 27 Feb 2022 00:00:00 +0000

Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition that lasts 3 months or more after an outbreak of shingles. Herpes zoster, especially acute herpes zoster, is associated with the reactivation of the inactivated varicella zoster virus in individuals who have had chickenpox. PHN is associated with persistent and often refractory neuropathic pain. Patients may experience several types of pain, including deep pain, intolerable pain, burning, paroxysmal pain, stabbing pain, hyperalgesia, and allodynia. Pharmacological treatment of PHN may include a variety of drugs, including alpha-2 delta ligands (gabapentin and pregabalin), other anticonvulsants (carbamazepine), tricyclic antidepressants (amitriptyline, nortriptyline, doxepin), topical analgesics (5% lidocaine patch, capsaicin) tramadol, or other opioids. The sizeable side effect profile of commonly used oral drugs often limits their practical use, and a combination of topical and systemic agents may be required for optimal results. Doctors and other care providers must adapt treatment based on individual patient responses.

HNP LUMBALIS

Mega Yulia Rusmayanti, Shahdevi Nandar Kurniawan — Wed, 01 Mar 2023 00:00:00 +0000

Lumbar herniated nucleus pulposus (HNP) is a disorder characterized by local displacement of the disc beyond the anatomical boundaries of the intervertebral space causing pain, weakness or numbness, and/or tingling in myotomal or dermatomal distribution. HNP is the most common cause of low back pain. Lumbar HNP itself has several underlying etiologies, such as old age, excessive axial load, connective tissue disorders, and congenital abnormalities. Management of HNP can be carried out non-operatively or operatively, depending on the severity, the symptoms that arise, and the response to non-operative treatment.

LEPROSY NEUROPATHY

Fahrani Yossa Prachika, Shahdevi Nandar Kurniawan — Mon, 13 Mar 2023 00:00:00 +0000

Leprosy is a major cause of peripheral neuropathy in developing countries, affecting sensory, motor, and autonomic nerve function. Neuropathy complications can include sensory loss and muscle weakness. Impaired sensory nerve function is often the first symptom encountered in leprosy neuropathy. Early detection and treatment of neuropathy in leprosy are important to prevent disability.

MYASTHENIA GRAVIS

Dewi Permata Sari, Shahdevi Nandar Kurniawan — Tue, 04 Apr 2023 00:00:00 +0000

Myasthenia gravis is an autoimmune disease of the postsynaptic membrane, especially acetylcholine receptors in the neuromuscular link of skeletal muscle. Patients with myasthenia gravis have a high number globally. The disease occurs due to a disorder that impairs the impulse connection between chemicals traveling from nerve endings and receptors. Clinical symptoms include weakness of the eye muscles (ptosis and diplopia), difficulty swallowing, and difficulty speaking. The diagnosis of myasthenia gravis is based on the patient's complaints obtained in the history, physical and neurological examination, and supporting examinations. The management that can be given is intravenous immunoglobulin (IVIg) therapy, plasma exchange (PE), corticosteroids given together with IVIg and PE, or acetylcholinesterase inhibitors. These treatments can determine the patient's prognosis. If the patient with myasthenia gravis is left to involve the respiratory muscles, then the patient's prognosis becomes worse. In addition, myasthenic crisis and cholinergic crisis may occur, which is a medical emergency.

PATHOPHYSIOLOGY IN CLUSTER HEADACHE: AN UPDATE

Wa Ode Intan Nur Octina, Shahdevi Nandar Kurniawan — Mon, 10 Apr 2023 00:00:00 +0000

Cluster headache (CH) is a rare and very painful primary headache syndrome, with an estimated population prevalence of 0.12%. This condition can be episodic (ECH), lasting from 7 days to a year. A consensus statement from the European Headache Federation defines refractory CCH as a CCH with at least three severe attacks per week, even though at least three consecutive trials of adequate preventive care have been tested and managed with both acute and preventive treatment. Inhaled oxygen and subcutaneous sumatriptan are the two most effective acute treatment options for people with CH. Several preventive medications are also available, and the most effective is verapamil. However, most of these agents are not supported by strong clinical evidence. In some patients, this option may be ineffective, particularly in those with chronic CH. Surgical procedures for chronic refractory forms of disorder should then be considered.