Cahyo - Indonesia

Trigeminal Neuralgia case :

Patient : Cahyo Mulyanto – INDONESIA : ■■■■■■■■■■■■■■■■■■■

Here is my medical history for initial info :

I've Trigeminal Neuralgia problem since more than 4-5 years ago at Maxillary area and I am a male 55 years old. The area of the pain is not stay in the same location all the time, it’s moving from time to time (such as from the cheek surface to few others area) Frequency of my attacks of my TN (fairly severe) is every few minutes (up and down depends on the condition)

I’ve an excellent health condition (not suffer from other ailment like asthma, thyroid disorder, diabetes, etc.), but poor control of my TN to the Nerve specialist doctor. But I’ve got CFS : Chronic Fatique Syndrome

  • X-ray sinus is normal and MRI is also normal (no compression cause of vascular by using very thin layer MRI method), the Radiolog concluded that it is IDIOPATHIC trigeminal neuralgia case.
  • HSV1 and HSV2 (IgG and IgM) are also negative/ clean.
  • Varicella herpes zoster test : IgG is High (positive) and IgM is low (negative), but this IgM result should not be used as a sole determinant of a current or recent infection.

So, I was trying to take Valtrex 1000mg x 3 a day for 10 days period (to treat herpes zoster/ shingles) + Methycobal (for peripheral neurophaties treatment) and Lyrica, but the result of this medicine is not effect to my TN.

  • Acupressure (by myself) seems not effective enough to increase the sensitivity of pain threshold.
  • My dentist was not founding something wrong from my Panoramix X-ray result event from AP and PA x-ray approach.
  • My ENT doctor just knowing an alergy in my nose after checking it by ENT endoscopy but, she was not judge that it is as the reason of causing my TN.
  • MRI in Indonesia (using very thin slices, use 3D Fiesta GE MRI ) and Singapore (1.5 T MRI) were not confirm any microvascular compression.
  • Gamma knife expert in Singapore says that this treatment is not my option after knowing my case.
  • Radiofrequency Rhizotomy (gasserian ganglion block), was not helping me well
  • I believe without family history of TN are relatively easier to handle. But now this medicine is not effect much anymore.
  • Medicine : B12 1000mg/ day was not helping & sometimes Neurobion

Enico, Methycobal 500, Frisium 1/3 + Haldol 0.25 mg and Tegretol 200 mg + Amythreptilin

Fundamin E

Mirtazapine 5


Keppra 250 mg

Lamotrigine/ Lamictal 50 mg

Tramadol, Paracetamol 500mg à no effect

Profenid + codein

Xanac 0.5 mg

Neurontin 150 mg + amitriptylin 15 mg + Riclona 1 mg in the night

Cymbalta 20 mg up to 40 mg

Remelon 7,5 mg

Nonflamin 50 mg/ Danzen 10,000 units

  • Go to the Gym (for body exercise) every day to optimize the stamina
  • Lab test : Routine hematology, faal hemostasis, urine routine, lever function, fat profile, immunologi, endocrine and metabolism Dec 2015 was good, except of High Gamma GT and Hyper-agregation Thrombosit
  • Accupuncture & TCM were not helping
  • Nanovibronix, continuous wave ultrasound 90kHz therapy every night for 6 hours
  • Consuming herbal (PALTYCERIUM CORONARIUM leaf) twice a day, see the attachment

When I am tired/ stress/ angry/ not slept well à TN symptom appears

- Is this classic symptoms of TN or atypical TN ?

Note :

In many cases these surgical procedures are not as successful for “atypical trigeminal neuralgia” or “atypical facial pain” and can actually make the pain worse. Thus, it is important to identify whether a condition is “atypical”. If the pain is constant or has a burning component, then the condition could have “atypical” features.