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Widodo Mardi Santoso
Universitas Brawijaya
Neuroscience

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POST HERPETIC NEURALGIA AND OPHTAMOPLEGIA IN PATIENT WITH MULTIPLE SCLEROSIS : A CASE REPORT Widodo Mardi Santoso; Yeni Quinta Mondiani; Machlusil Husna; Rodhiyan Rachmatiar
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (209.476 KB) | DOI: 10.21776/ub.jphv.2020.001.01.3

Abstract

Zoster Herpes which is also known as ‘shingles’ may cause infection on neuro system through the reactivation of the virus. This infection causes skin eruption along the affected dermatomal distribution and it is called post herpetics neuralgia. This condition occurs on approximately 9-15% patients of zoster herpes who receive no treatment. Elderly women have a higher risk of the condition. Complete oftamoplegia is also related with zoster herpes. It was reported that there were 16 cases in the past one year with a relatively good prognosis (total recovery within 18 months) with an analysis starting from inflammation of trigeminus nervus to cavernosus sinus, cranialis nervus microinfark caused by vasculitis, meningeal inflammation, and demyelinisation (of autopsy). On the other hand, there are theories showing a correlation between zoster herpes infection and multiple sclerosis. Based on the epidemiologic study which has been conducted, that zoster herpes is influencing multiple sclerosis. This virus might induce autoimmune cascade and proinflammatory via particle like Toll – like receptor 4 (TLR-4).
TRIGEMINAL NEURALGIA CAUSED BY ARTERIOVENOUS MALFORMATION OF THE POSTERIOR FOSSA : A CASE REPORT Widodo Mardi Santoso; Opik Jamaludin; Catur Ari Setianto; Neila Raisa
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (238.825 KB) | DOI: 10.21776/ub.jphv.2020.001.01.4

Abstract

Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Trigeminal neuralgia has a prevalence of 0.1-0.2 per thousand and an incidence ranging from about 4-5/100,000/year up to 20/100,000/year after age 60. A 35 year old woman presented with 1 year history of right facial pain. Physical examination showed hyperalgesia and allodynia in all division of right trigeminal nerve. Magnetic resonance imaging with contrast demonstrated flow void signal in the right cerebellopontine angle. Computed tomography angiography confirmed the diagnosis of AVM (arteriovenous malformation), and demonstrated the malformed niduses were fed by the right posterior inferior cerebellar artery and the right superior cerebellar artery, and drained vein into basal vein of rosenthal, without hemorrhage or aneurysm intranidal appearance. carbamazepin 2x100 mg per oral for 7 days effectively decreased the facial pain significantly (from the numeric rating scale (NRS) score 8 to 5). Open surgical was not prefered for this patient because the AVM was small, unruptured, and located in eloquent area. Radiosurgery is considered if the medication fails. Trigeminal neuralgia with facial pain affecting all devision of nervus trigeminus with pulsatile headache can be suspected symptomatic TN. Radiological examination such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) angiography can be performed to detect the cause of TN.
COMPARATIVE OF INTRAARTICULAR INJECTION BETWEEN DEXTROSE PROLOTHERAPY VERSUS TRIAMCINOLONE ACETONIDE IN KNEE OSTEOARTHRITIS Widodo Mardi Santoso; Andhy Indriyono; Badrul Munir; Alidha Nur Rakhmani; Machlusil Husna
Journal of Pain, Headache and Vertigo Vol. 1 No. 2 (2020): September
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (292.991 KB) | DOI: 10.21776/ub.jphv.2020.001.02.1

Abstract

Knee osteoarthritis (OA) is one of the most common cartilage degenerative disorders that is a major problem because it causes chronic pain and disability. Therefore the method of treatment and prevention of old age is a big challenge. The results of Dextrose Prolotherapy compared to Triamcinolone therapy research are still varied. Objective:  to  compare  the effectiveness  of  Dextrose  Prolotherapy  and  Triamcinolone Acetonide (TA) in the treatment of moderate knee knee OA.True experimental single blind study, at the Neurology Polyclinic Dr. Saiful Anwar General Hospital Malang for 6 months (July-December 2019). Group I; Dextrose Prolotherapy (15%) intraarticularly injected 3 times every 4 weeks and group II; TA one- time intraarticular injection. The parameters studied were The Western Ontario and McMaster  Universities  Osteoarthritis  Index  (WOMAC)  Score,  Numeric  Rating  Scale (NRS), and Range of Motion (ROM), weeks 0, 4, 8, 12 and 24. Forty samples consisted of; the 20 samples of the Dextrose Prolotherapy group consisted of; male: female = 2 (10%): 18 (90%), age 62.4 + 7.28, BMI 25.6 + 3.69 kg / m2, pain duration 22.35 + 20.10 months, history of physiotherapy 40.27 + 20.79 times. Kellgren–Lawrence osteoarthritis severity grade II; 17 (85%), grade III 3 (15%). TA group; male: female = 5 (25%):15 (75%), age 62.5 + 9.02, BMI 28.4 + 5.01 kg/m2, pain duration 15.95 +  16.55  months,  history  of  physiotherapy  34  +  24.87  times.  Kellgren  –  Lawrence osteoarthritis severity grade II; 18 (90%), grade III; 2 (10%). Comparison of NRS at rest Dextrose Prolotherapy vs TA of week 4 (2.60 vs 1.25), week 8 (1.65 vs 1.40), week 12 (0.8 vs 2.05), week 24 (0.75 vs 3.35). Comparison of NRS during activity Dextrose Prolotherapy vs TA week 4 (4.45 vs 3.35), week 8 (3.25 vs 3.55), week 12 (2.55 vs 4.30), week 24 (2.55 vs 5.80). Comparison of ROM flexion Dextrose Prolotherapy vs TA week 4 (127.05° vs 123.60°), week  8  (130.85°  vs  122.95°),  week  12  (130.85°  vs  122.95°),  week  24  (131.05°  vs 122.10°). Comparison of WOMAC score Dextrose Prolotherapy vs TA week 4 (30.05 vs 22.45), week 8 (22.90 vs 23.95), week 12 (19.30 vs 29.05), week 24 (18.95 vs 35.40). Intraarticular Injection Dextrose Prolotherapy is more effective for the long term based on pain scale NRS, WOMAC score and ROM. Whereas short-term TA is more effective than Dextrose Prolotherapy.
RADIOFREQUENCY AS PAIN INTERVENTIONAL THERAPY IN NEUROLOGY Badrul Munir; Widodo Mardi Santoso; Zamroni Afif; Shahdevi Nandar Kurniawan
Journal of Pain, Headache and Vertigo Vol. 1 No. 2 (2020): September
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (234.177 KB) | DOI: 10.21776/ub.jphv.2020.001.02.3

Abstract

Radiofrequency (RF) intervention uses high frequency alternating current (AC) to inhibit and alter nociceptive pathway in various locations. Radiofrequency is divided into Continuous RF (CRF) and Pulsed RF (PRF). Continuous RF is a process in which the RF current is used to produce thermal lesions on the target nerve that will result in resistance to the afferent nociceptive pathway. PRF is a process whereby short bursts of RF are discharged toward a neural target that will produce a signal for lowering pain. PRF is a therapy of neural tissue with small neurodestructive possibility and is an alternative technique for continuing RF. RF therapy is a minimally invasive procedure that has been used for about three decades to treat various chronic pain syndromes such as trigeminal neuralgia, post herpes neuralgia, lower back pain (LBP), and complex regional pain syndromes or sympathetic reflex dystrophy. The mechanism action of the PRF involves cellular structure damage, neuronal activation, altered gene expression, a global continuation of evoked synaptic  activity in pain fibers through centrals and changes in synaptic strength and long-term potentiation.  PRF with its various characteristics has a better outcome than conventional RF.
LOW BACK PAIN Andaru Cahya S; Widodo Mardi Santoso; Machlusil Husna; Badrul Munir; Shahdevi Nandar Kurniawan
Journal of Pain, Headache and Vertigo Vol. 2 No. 1 (2021): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (499.777 KB) | DOI: 10.21776/ub.jphv.2021.002.01.4

Abstract

Low back pain is the most common symptom found in the primary health care and is the number one cause of disability throughout worldwide. It is estimated that around 60 – 80% the world population will experience back pain during their lifespan. There are three different source of pain in the spine: axial-lumbosacral, radicular and reffered pain. All of these source brings different clinical presentations. Low back pain could be classified as acute, subacute and chronic low back pain. The pain could be nociceptive or neuropathic, the most common symptoms reported are “pressure pain” and “pain attack”.  The physician should be aware of “red flags” symptoms that lead into more serious condition beside back pain and, therefore the patient has to be investigated to further examination whenever these symptoms present. The management of low back pain consist of severe modalities, both therapeutic and rehabilitative procedure. Oftentimes, the management needed multidisciplinary approach. It is important to general practitioners to identify and treat low back pain appropriately to reduce the burden of the disease and to prevent the disabilties caused by this condition.
PROFILE OF PRIMARY HEADACHE PATIENTS IN NEUROLOGICAL POLYCLINIC Yulia Damayanti; Eko Arisetijono Marhaendraputro; Widodo Mardi Santoso; Dessika Rahmawati
Journal of Pain, Headache and Vertigo Vol. 2 No. 1 (2021): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (354.17 KB) | DOI: 10.21776/ub.jphv.2021.002.01.1

Abstract

Headache is the most common neurological disorder among all the symptoms of general health problems. Headaches are the most frequently complained of after back pain, which brings someone to the doctor and harms personal, family, social, quality of life, work, and finances. This study aims to find out the characteristics of primary headache patients in the neurological polyclinic, RSUD dr. Saiful Anwar Malang. The design of this research was an observational descriptive study of the filled headache questionnaire was to determine the characteristics of headache patients who visited the neurological polyclinic at dr. Saiful Anwar Malang with complaints of primary headache. The procedure of this research is to provide a questionnaire. The data analysis technique used is that the research variables will be presented in the frequency distribution table. The results of this research show that primary headache was more common in women as many as 19 people (61%) compared to male 12 people (39%). Most of the primary headache patients who came to the neurological clinic of Saiful Anwar Hospital were 30-60 years old. Tension-Type Headache (TTH) in this study had the highest percentage of 58%. In this study, cluster headache two patients all attacked women.
COMPARISON OF HYDRODISECTION INJECTION BETWEEN TRIAMCINOLONE ACETONIDE VERSUS DEXAMETHASONE IN CARPAL TUNNEL SYNDROME Widodo Mardi Santoso; Badrul Munir; Catur Ari Setianto; Ria Damayanti; Sheny Agma
Journal of Pain, Headache and Vertigo Vol. 2 No. 2 (2021): September
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (329.781 KB) | DOI: 10.21776/ub.jphv.2021.002.02.1

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common nontraumatic peripheral neuropathy, which is caused by suppression of the median nerve below the transverse carpi ligament. Local corticosteroid injection is considered the fastest and most effective method for improving symptoms that occur in CTS. There are several corticosteroid agents that can be used, but there are no objective standards that can explain the most ideal drugs. Objective: To compare the effectiveness of hydrodisection injection therapy of triamcinolone acetonide versus dexamethasone on carpal tunnel syndrome. Methods: This study involved 30 participants who were diagnosed with CTS and fulfilled the inclusion criteria and no exclusion criteria were obtained. Participants were divided into two treatment groups; the first group (n = 15) injected with Triamcinolone Acetonide (TCA) 10mg / 1ml and lidocaine 1% 1 ml and the second group (n = 15) injected with Dexamethasone 4mg / 0.8ml and lidocaine 1% 1 ml. The NRS, FSS, and SSS parameters were assessed before injection and 4 weeks after injection in each agent. Then compared these parameters at 4 weeks after injection compared to the TCA group with the dexamethasone group. Results: NRS score before and 4 weeks after TCA injection (sig 0.000; p <0.05), SSS (sig 0.001; p <0.05) and FSS (sig 0.020; p <0.05), and NRS score before and 4 weeks after dexamethasone injection (sig 0.001; p <0.05), SSS (sig 0,000; p <0.05) and FSS (sig 0,000; p <0.05). At 4 weeks after injection of TCA compared to dexamethasone there were no significant results on NRS (sig 0.237; p> 0.05) and FSS (sig 0.119; p> 0.05), while SSS values were significantly different (sig 0.027; p <0.05). Conclusion: Significant improvement in NRS, FSS and SSS score was obtained at 4 weeks after hydrodisection injection, both with TCA and dexamethasone. At 4 weeks after TCA injection compared to dexamethasone, there were no significant differences in NRS and FSS scores, whereas SSS score differed significantly. Both injection agents are equally effective in treating CTS, but dexamethasone produces a better improvement in SSS score.
POST HERPETIC NEURALGIA AND OPHTAMOPLEGIA IN PATIENT WITH MULTIPLE SCLEROSIS : A CASE REPORT Widodo Mardi Santoso; Yeni Quinta Mondiani; Machlusil Husna; Rodhiyan Rachmatiar
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2020.001.01.3

Abstract

Zoster Herpes which is also known as ‘shingles’ may cause infection on neuro system through the reactivation of the virus. This infection causes skin eruption along the affected dermatomal distribution and it is called post herpetics neuralgia. This condition occurs on approximately 9-15% patients of zoster herpes who receive no treatment. Elderly women have a higher risk of the condition. Complete oftamoplegia is also related with zoster herpes. It was reported that there were 16 cases in the past one year with a relatively good prognosis (total recovery within 18 months) with an analysis starting from inflammation of trigeminus nervus to cavernosus sinus, cranialis nervus microinfark caused by vasculitis, meningeal inflammation, and demyelinisation (of autopsy). On the other hand, there are theories showing a correlation between zoster herpes infection and multiple sclerosis. Based on the epidemiologic study which has been conducted, that zoster herpes is influencing multiple sclerosis. This virus might induce autoimmune cascade and proinflammatory via particle like Toll – like receptor 4 (TLR-4).
TRIGEMINAL NEURALGIA CAUSED BY ARTERIOVENOUS MALFORMATION OF THE POSTERIOR FOSSA : A CASE REPORT Widodo Mardi Santoso; Opik Jamaludin; Catur Ari Setianto; Neila Raisa
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2020.001.01.4

Abstract

Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Trigeminal neuralgia has a prevalence of 0.1-0.2 per thousand and an incidence ranging from about 4-5/100,000/year up to 20/100,000/year after age 60. A 35 year old woman presented with 1 year history of right facial pain. Physical examination showed hyperalgesia and allodynia in all division of right trigeminal nerve. Magnetic resonance imaging with contrast demonstrated flow void signal in the right cerebellopontine angle. Computed tomography angiography confirmed the diagnosis of AVM (arteriovenous malformation), and demonstrated the malformed niduses were fed by the right posterior inferior cerebellar artery and the right superior cerebellar artery, and drained vein into basal vein of rosenthal, without hemorrhage or aneurysm intranidal appearance. carbamazepin 2x100 mg per oral for 7 days effectively decreased the facial pain significantly (from the numeric rating scale (NRS) score 8 to 5). Open surgical was not prefered for this patient because the AVM was small, unruptured, and located in eloquent area. Radiosurgery is considered if the medication fails. Trigeminal neuralgia with facial pain affecting all devision of nervus trigeminus with pulsatile headache can be suspected symptomatic TN. Radiological examination such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) angiography can be performed to detect the cause of TN.
COMPARATIVE OF INTRAARTICULAR INJECTION BETWEEN DEXTROSE PROLOTHERAPY VERSUS TRIAMCINOLONE ACETONIDE IN KNEE OSTEOARTHRITIS Widodo Mardi Santoso; Andhy Indriyono; Badrul Munir; Alidha Nur Rakhmani; Machlusil Husna
Journal of Pain, Headache and Vertigo Vol. 1 No. 2 (2020): September
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2020.001.02.1

Abstract

Knee osteoarthritis (OA) is one of the most common cartilage degenerative disorders that is a major problem because it causes chronic pain and disability. Therefore the method of treatment and prevention of old age is a big challenge. The results of Dextrose Prolotherapy compared to Triamcinolone therapy research are still varied. Objective:  to  compare  the effectiveness  of  Dextrose  Prolotherapy  and  Triamcinolone Acetonide (TA) in the treatment of moderate knee knee OA.True experimental single blind study, at the Neurology Polyclinic Dr. Saiful Anwar General Hospital Malang for 6 months (July-December 2019). Group I; Dextrose Prolotherapy (15%) intraarticularly injected 3 times every 4 weeks and group II; TA one- time intraarticular injection. The parameters studied were The Western Ontario and McMaster  Universities  Osteoarthritis  Index  (WOMAC)  Score,  Numeric  Rating  Scale (NRS), and Range of Motion (ROM), weeks 0, 4, 8, 12 and 24. Forty samples consisted of; the 20 samples of the Dextrose Prolotherapy group consisted of; male: female = 2 (10%): 18 (90%), age 62.4 + 7.28, BMI 25.6 + 3.69 kg / m2, pain duration 22.35 + 20.10 months, history of physiotherapy 40.27 + 20.79 times. Kellgren–Lawrence osteoarthritis severity grade II; 17 (85%), grade III 3 (15%). TA group; male: female = 5 (25%):15 (75%), age 62.5 + 9.02, BMI 28.4 + 5.01 kg/m2, pain duration 15.95 +  16.55  months,  history  of  physiotherapy  34  +  24.87  times.  Kellgren  –  Lawrence osteoarthritis severity grade II; 18 (90%), grade III; 2 (10%). Comparison of NRS at rest Dextrose Prolotherapy vs TA of week 4 (2.60 vs 1.25), week 8 (1.65 vs 1.40), week 12 (0.8 vs 2.05), week 24 (0.75 vs 3.35). Comparison of NRS during activity Dextrose Prolotherapy vs TA week 4 (4.45 vs 3.35), week 8 (3.25 vs 3.55), week 12 (2.55 vs 4.30), week 24 (2.55 vs 5.80). Comparison of ROM flexion Dextrose Prolotherapy vs TA week 4 (127.05° vs 123.60°), week  8  (130.85°  vs  122.95°),  week  12  (130.85°  vs  122.95°),  week  24  (131.05°  vs 122.10°). Comparison of WOMAC score Dextrose Prolotherapy vs TA week 4 (30.05 vs 22.45), week 8 (22.90 vs 23.95), week 12 (19.30 vs 29.05), week 24 (18.95 vs 35.40). Intraarticular Injection Dextrose Prolotherapy is more effective for the long term based on pain scale NRS, WOMAC score and ROM. Whereas short-term TA is more effective than Dextrose Prolotherapy.
Co-Authors Andaru Cahya S Andhy Indriyono Badrul Munir Catur Ari Setianto Damayanti, Ria Dessika Rahmawati Eko Arisetijono Machlusil Husna Mondiani, Yeni Quinta Opik Jamaludin Raisa, Neila Rakhmani, Alidha Nur Rodhiyan Rachmatiar Shahdevi Nandar Kurniawan, Shahdevi Nandar Sheny Agma Yulia Damayanti Zamroni Afif