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Shahdevi Nandar Kurniawan
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Neurology Department, Faculty of Medicine, Brawijaya University Jl. JA Suprapto No. 2 Malang, Indonesia 65112
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Journal of Pain, Vertigo and Headache
Published by Universitas Brawijaya
ISSN : 27233979     EISSN : 27233960     DOI : https://doi.org/10.21776/ub.jphv
Core Subject : Science,
Neuroscience
JPHV - Journal of Pain, Headache and Vertigo is a peer-reviewed and open access journal that focuses on promoting pain, headache and vertigo. This journal publishes original articles, reviews, and also interesting case reports. JPHV - Journal of Pain, Headache and Vertigo is an international scientific journal, published twice a year by PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia.
Arjuna Subject : Ilmu Syaraf - Neorologi
Articles 103 Documents
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COMPARATIVE EFFICACY AND SAFETY OF DULOXETINE AND GABAPENTINOID FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A SYSTEMATIC REVIEW Zahradewi, Olympia; Kurniawan, Shahdevi Nandar; Budisulistyo, Trianggoro
Journal of Pain, Headache and Vertigo Vol. 7 No. 2 (2026): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is chemotherapy’s side effect that can last for years even after treatment stopped. The prevalence after chemotherapy is 68% in the first month. Chemotherapy’s main mechanism is the disruption of the depolymerization cycle of microtubules in the myelin sheath, which interferes with nerve transmission and causes tingling, numbness, and severe pain. Current management of CIPN are antidepressant medications, such as duloxetine, and gabapentinoids (pregabalin and gabapentin). Objective: This systematic review aims to provide comparison of the efficacy and safety between two drugs in reducing neuropathy on CIPN patients, due to lack of previous systematic review on this topic. Methods: A literature review search was conducted in the PubMed database, Sage Journal, and other sources until the date 10th September 2025. Results: Using VAS score, duloxetine showed less capability to lower pain which is around 30.5%, while gabapentinoid by VAS score showed around 73.4%. But when it comes to adverse effect, duloxetine suggested more less severity, such as nausea, dizziness, fatigue, headache, and insomnia; whereas gabapentinoid can cause somnolence, dizziness, ataxia, diplopia, blurred vision, sedation, drowsiness, pedal edema, swelling of the face and eyelids, while the rest developed excessive sedation. Conclusions: Duloxetine is effective and consistent in reducing CIPN compared to gabapentinoids; with gabapentin being superior to pregabalin. This review’s limitation lies in the few studies discussing the efficacy of both drugs on CIPN.
BREAKING BARRIERS: FIRST SUCCESSFUL THROMBOLYSIS FOR HYPERACUTE ISCHEMIC STROKE IN A REGIONAL HOSPITAL (SERANG DISTRICT CASE REPORT) Widyantari, Diryati; Fahmi, Chaidir Aulia
Journal of Pain, Headache and Vertigo Vol. 7 No. 2 (2026): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Stroke is the leading cause of disability worldwide, with ischemic stroke comprising up to 80% of cases. Code stroke activation with intravenous thrombolysis is the recommended treatment for eligible patients within 4.5 hours of symptom onset. Reports from secondary health care facilities remain limited. Case Report: A 57-year-old woman presented to the emergency department with sudden-onset left-sided weakness and aphasia, 2 hours after onset. Examination showed left hemiparesis (motor strength 3), global aphasia, dysarthria, and tongue weakness, with an NIHSS score of 14. Brain CT scan suggested early ischemic changes. Random blood glucose was 103 mg/dL. After confirming eligibility and obtaining informed consent, intravenous alteplase was administered within 60 minutes. During infusion, her neurological deficits improved, with NIHSS reduced to 8. She was admitted to the intensive care unit for observation with NIHSS score downed into 3. By the next day, motor strength was restored (5-/5-), with NIHSS 1. She was discharged on day three without neurological deficits (NIHSS 0). Conclusion: This case represents an important milestone in our institution, showing that code stroke protocols can be successfully implemented in regional hospitals. Prompt thrombolysis in patients with moderate ischemic stroke may result in complete recovery and prevent long-term disability.
CONSERVATIVE MANAGEMENT OF CEREBELLAR ABSCESS IN A PRIMARY HOSPITAL Dzakiyyah, Nasywa Florean; Inggrianita, Dotti
Journal of Pain, Headache and Vertigo Vol. 7 No. 2 (2026): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: A cerebral abscess is a pus-filled, encapsulated area in the brain with risk of neurological deficit. MRI is the gold-standard modality for brain abscesses. Case Report: A 36-year-old woman came with progressively worsening headache for one year, accompanied by dizziness and nausea. Cranial nerve and motoric function were normal. Meningeal signs were negative. History of infection or trauma was denied. Contrast-enhanced MRI showed a lesion in the right cerebellum with rim enhancement. The patient was advised to be referred to neurosurgery, but declined. With conservative therapy of cefixime and dexamethasone, symptoms briefly reduced, but then came back. On latest examination we found unidirectional nystagmus to the right, positive Romberg test, left and right dysdiadochokinesia, with slight weakness in right arm (motoric 4+). Past pointing and intention tremor test was normal. Latest lab showed increased ESR.Discussion: Symptoms of a cerebral abscess are often non-specific. Abscess in the cerebellum is rare, most are located in the frontal or temporal lobes. Management of cerebral abscesses combines a medical and surgical approach. Intravenous antibiotics are preferred, but not feasible in our outpatient setting.  Monitoring of treatment involves neurological exams, blood tests, and brain imaging. Conclusion: Conservative management of cerebral abscess are unusual and, although brief, the symptoms respond to the therapy. Monitoring is essential to adjust the treatment, but the lack of facilities in a primary hospital impedes the ideal treatment. The patient is urged to reconsider surgery given the latest outcome.

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