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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 92 Documents
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PAINFUL NEURALGIA RELATED RAMSAY HUNT SYNDROME: A CASE REPORT Pinzon, Rizaldy Taslim; Pandita, Felicia Dara Puspitaning
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
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/ub.jphv.2025.006.01.01

Abstract

Ramsay Hunt Syndrome is a rare case.  This syndrome is a severe complication of the reactivation of varicella zoster virus in the geniculate ganglion. Facial paralysis is the main clinical presentation.  We present a rare case Ramsay Hunt Syndrome in a 48 year old female that referred to neurology clinic with very painful herpetic neuralgia, left ear discomfort, and facial palsy. The patient came after two weeks eruption of herpetic rash in the second and third branch of trigeminal nerve. Treatment as antiviral, steroid, gabapentin, and amitriptyline showed improvement and significantly reduced the pain in this patient.
COMPREHENSIVE REHABILITATION APPROACH FOR MEDIAN NERVE NEUROPATHY COMPLICATED BY CERVICAL RADICULOPATHY: CASE REPORT IN A YOUNG GAME Yudiansyah, Anggi Gilang; Kurniawan, Shahdevi Nandar; Lestari, Dwi Indriani; Pringga, Gutama Arya
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
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/ub.jphv.2025.006.01.02

Abstract

Background: Median nerve neuropathy, particularly associated with repetitive strain activities such as gaming, is increasingly recognized in clinical practice. This condition often necessitates a multidisciplinary and holistic approach for effective management, aiming to prevent long-term complications and improve functional outcomes. Case: A 21-year-old male presented with progressive weakness, paresthesia, and atrophy in the first three digits of both hands, attributed to excessive gaming, exceeding 12 hours daily. Neurological examination revealed marked weakness in muscles innervated by the median nerve, and electromyography (EMG) confirmed bilateral median nerve compression, compounded by cervical radiculopathy at the C6-7-8-T1 levels. Discussion: This case underscores the necessity of evaluating both peripheral nerve pathology and potential cervical radiculopathy in patients with extensive upper limb use. Intensive gaming, characterized by poor ergonomic practices, can exacerbate nerve compression, leading to significant neuropathic changes. The implemented multidisciplinary rehabilitation approach involved patient education on ergonomic modifications, targeted physical therapy to strengthen affected muscle groups, and strategies to optimize posture and reduce repetitive strain. This comprehensive intervention aimed to alleviate symptoms, restore function, and prevent further deterioration. Conclusion: The case highlights the complexities involved in managing median nerve neuropathy exacerbated by cervical radiculopathy in individuals engaged in repetitive, high-intensity activities. A comprehensive, evidence-based rehabilitation strategy is crucial for achieving optimal recovery, minimizing recurrence, and enhancing the patient’s quality of life. Further research is warranted to explore the long-term efficacy of such interventions and to develop tailored rehabilitation protocols for similar cases in the gaming community.
NON-SURGICAL MANAGEMENT OF CHRONIC RADICULAR PAIN IN LUMBAR CANAL STENOSIS: A CASE REPORT ON THE EFFICACY OF PULSED RADIOFREQUENCY Aprilia, Arvidareyna Panca; Kurniawan, Shahdevi Nanda
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
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/ub.jphv.2025.006.01.03

Abstract

Background: Low back pain (LBP) is a prevalent condition, particularly in adults aged 40 to 80 years, and is often associated with lumbar canal stenosis. This condition leads to nerve compression, causing radicular pain that radiates to the lower extremities. Non-surgical options such as Pulsed Radiofrequency (PRF) have emerged as effective treatments for patients with chronic radicular pain who do not respond to conservative therapy. Case: We report a case of a 49-year-old female presenting with a three-year history of progressively worsening LBP, radiating to both legs. MRI revealed mild lumbar canal stenosis and posterior listhesis grade I at L3-L4, with bilateral nerve root compression at L4-L5 and S1. Conservative therapy, including physical therapy and pharmacological treatment, provided minimal relief. PRF therapy was subsequently applied to the L4-L5 and S1 nerve roots, resulting in significant pain reduction (NRS 7-8 to 5-6) and improved function. Discussion: Lumbar canal stenosis often leads to neurogenic claudication and radicular pain due to nerve compression. Posterior listhesis exacerbates this condition by contributing to spinal instability. PRF offers a minimally invasive alternative to surgery, with studies showing its efficacy in modulating nociceptive pathways and reducing pain. In this case, PRF effectively reduced pain and improved mobility, offering a safe and efficient treatment option. Conclusion: PRF is an effective non-surgical intervention for managing chronic radicular pain due to lumbar canal stenosis. Its integration into chronic low back pain management protocols and patient education offers significant benefits.
DOES SERUM C-REACTIVE PROTEIN HAVE CORRELATION WITH THE SEVERITY OF ACUTE ISCHEMIC STROKE? Salma, Kayla Maritza Putri; Rakhmatiar, Rodhiyan; Eko Arisetijono Marhendraputro
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
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/ub.jphv.2025.006.01.04

Abstract

Background: Ischemic stroke can trigger an inflammatory response in the body. C-Reactive Protein is a biomarker that is elevated during inflammation. There is various evidence about correlation between CRP levels and the severity of ischemic stroke. Objective: To identify the correlation of CRP levels with stroke severity based on the National Institutes of Health Stroke Scale (NIHSS). Methods: A descriptive retrospective analytic study was used, and data were obtained from medical records of acute ischemic stroke patients in the Neurology Department of Saiful Anwar Hospital for 3 years. Subject characteristics analyzed were CRP levels, severity of ischemic stroke based on the NIHSS scale, and risk factors of ischemic stroke (age, gender, blood pressure, atrial fibrillation, infection, and random blood sugar). CRP levels and NIHSS scale were compared using Mann Whitney comparison test. Results: Out of 332 patients, 39 patients met the inclusion criteria. The amount of patient above 55 years old was 22 people (56.41%). The gender ratio was 19 men (48.72%) and 20 women (51.28). In the risk factor section, 35 people (89.74%) had hypertension, 11 people (28.21%) had atrial fibrillation, 17 people (43.59%) had infections, and 5 people (12.82%) had high random blood sugar. The comparison test showed that there was an increase in CRP levels along with the severity of stroke according to NIHSS mild-moderate and severe-very severe (p = 0.701). Conclusion: There is no significant relationship between CRP levels and the severity of stroke based on NIHSS.
NON-TRAUMATIC SUBARACHNOID HEMORRHAGE IN A 57-YEAR-OLD WOMAN WITH A LONG HISTORY OF VERTIGO: CASE REPORT Putri, Berlian Ristina; Satiadarma, Tiffany; Mawaddah, Syarifiyana; Indriyono, Andhy
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
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/ub.jphv.2025.006.01.05

Abstract

Background: Indonesia has a high burden of stroke, became the number one cause of death. Among countries in Asia, Indonesia has the highest stroke mortality rate. Ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage were sequentially the highest to lowest prevalence of stroke. Subarachnoid hemorrhage most often causes severe headaches which patients may describe as the worst headache of their life, accompanied by vomiting and stiff neck. Focal neurological deficits to coma can appear depending on the severity of the disease. Vertigo is an alarming symptom that could indicate the existence of an unruptured intracranial aneurysms that predominantly causes non traumatic subarachnoid hemorrhage. Case: A 57-year-old woman came to the emergency room with decreased consciousness GCS E3V1M4 after falling in the bathroom 30 minutes before admission. Accompanying complaints were projectile vomiting. The patient had a history of chronic vertigo. History of hypertension, diabetes and smoking were denied. From physical examination neck stiffness, positive Brudzinski I, and right laterality were found. Non-contrast head CT scan findings showed subarachnoid and intraventricular hemorrhage. Leukocytosis (16,300/μL) and hypokalemia (2.8 mmol/L) were found in laboratory examinations. Mannitol, citicoline, acetazolamide, nimodipine, ketorolac, ondansetron, and ranitidine were given. The patient experienced clinical improvement after 18 hours of treatment in the ICU with GCS increase to E3V5M6. After 15 days of hospitalization, the patient experienced significant clinical improvement. Conclusion: Recognition of risk factors, early diagnosis, and management of subarachnoid hemorrhage are important in preventing morbidity and mortality and improving patient outcomes.
PREVALENCE OF NEUROPATHIC PAIN IN LOW BACK PAIN PATIENTS AT COMMUNITY HEALTH CENTER M, Muna; Pambudi, Pagan
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): 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/ub.jphv.2025.006.02.01

Abstract

Low back pain (LBP) is a musculoskeletal disorder that is widely found in the community starting at the age of 25 years and increasing at 50 years. Patients who experience LBP mostly experience neuropathic pain as much as 37% which complicates management. The neuropathic pain component is rarely considered in First Level Health Facilities (FKTP) due to lack of knowledge about simple clinical instruments that can identify pain characteristics and lack of data or research on neuropathic pain in LBP in FKTP so that the management of neuropathic pain in LBP in FKTP is less comprehensive. Therefore, research on neuropathic pain in LBP patients in primary care facilities needs to be done. This research aim to determine the prevalence of neuropathic pain among LBP patients at Puskesmas Simpang Empat 2 Banjar Regency. The study approach used was descriptive, using variables such as Low Back Pain (LBP), age, and gender. This research included LBP patients from Puskesmas Simpang Empat. 2.The research employed Pain Detection Questionnaire (PD-Q). The sample method used was incidental sampling. The results shows that During the study period, 95 samples were collected, with LBP patients with neuropathic pain accounting for 42 (44.2%), nociceptive 32 (33.7%), and ambiguous 21 (22.1%). According to gender, 58.9% were women and 41.1% were men. The greatest age group (40-49 years) had a frequency of 27.4%, while the lowest frequency (<20 years) was only 1.1%. Neuropathic pain is a prevalent issue in clinical practice.
CHARACTERISTICS OF LOW BACK PAIN IN NEUROLOGY OUTPATIENT Arnetha, Tiffani Shavira; Devy, Monica Sari; Payangan, Natan
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): 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/ub.jphv.2025.006.02.4

Abstract

Introduction: Low back pain is a significant global health issue. This condition not only causes physical discomfort but can also reduce the quality of life and productivity of individuals. This study aims to determine the characteristics of patients with low back pain at  Mampang Prapatan General Hospital. Methods: This study was a descriptive cross-sectional study using secondary medical record data from Mampang Prapatan General Hospital  in 2024. The sampling technique used in this study was simple random sampling. Results: There were 40 samples in this study, 31 samples were female (77.5%) and 9 samples were male (22.5%). The average age was 55.6 years old, with the largest age group being those over 60 years old (42.5%). The most common nutritional status was grade 1 obesity (47.5%). Radiating pain was most frequently reported pain (67.5%). Radiological examination using lumbosacral x-ray showed that the most common finding was lumbar spondylosis (57.5%). The most commonly used treatment was a combination of pharmacological and non-pharmacological therapy, specifically physiotherapy combined with analgesics and anti-spasmodic drugs. Conclusion: It can be concluded that the distribution of low back pain patients at Mampang Prapatan General Hospital were most prevalent among females, elderly individuals (>60 years), had obese nutritional status, and experienced radiating pain symptom. A combination of pharmacological and non-pharmacological management can be used to improve the quality of life for patients with low back pain.
A RARE CASE OF ISCHEMIC STROKE IN A YOUNG WOMAN WITH AUTOIMMUNE DISEASE: DIAGNOSIS AND THERAPY CHALLENGES Bulain, Stanley; Atalia, Arila; Lestari, Hotma; Pamarta, Trisna Belani; Rakhmatiar, Rodhiyan
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): 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/ub.jphv.2025.006.02.02

Abstract

Introduction: Stroke is a leading cause of death and disability worldwide and is considered a disease of the elderly. However, recent trends indicate an increase in stroke cases in young adults due to autoimmune causes. Stroke in young adults directly impacts health, productivity, society, the economy, and the health system. Case: A 30-year-old woman presented with sudden, intermittent weakness of one half of her body for 2 days. Physical examination revealed mild paralysis of the right 7th and 9th nerves, hemiparesis, hemihypesthesia, hemiparesthesia, increased physiological reflexes, and positive Hoffman and Tromner reflexes in the right extremity. A CT scan was normal, and the ANA test was positive. The patient was hospitalized for 7 days and given citicoline 500 mg once, azathioprine 50 mg twice, hydroxychloroquine 1200 mg once, acetylsalicylic acid 200 mg once, and pulse methylprednisolone 125 mg four times. She gradually improved. The patient was referred to the RSSA for MRI and MRA, which revealed a chronic infarction extending from the corona radiata to the left lentiform nucleus and no visible ACA segment A1 structure. The patient experienced a generalized tonic-clonic seizure lasting 2 minutes during the DSA. Diazepam 7.5 mg, Metamizole 1 g, and Nicardipine 3 mg/hour were administered, and the patient subsequently regained consciousness. The DSA results showed total occlusion of the ACA segment A1. The patient was diagnosed with CVA infarction with total occlusion of the ACA segment A1, with suspected autoimmune disorder. The patient was discharged three days later and planned for observation. Conclusion: Ischemic stroke in young adults with autoimmune disorders is a serious condition that requires special attention. Antiphospholipid antibody-related hypercoagulability and vascular complications such as vasculitis are the main mechanisms of stroke in this population. Further evaluation for underlying autoimmune disease is necessary for further treatment decisions.
EFFICACY OF ROBOT-ASSISTED THERAPY FOR ANKLE REHABILITATION IN STROKE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS Michelle Taruna, Dea; Athifah Nur Azizah Arif; Izzati, Nisrina Khansa; Salsabila, Pricillia Laurenza; Adams, Fayyaza Faiz
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): 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/ub.jphv.2025.006.02.03

Abstract

Introduction: Stroke is characterized by an obstruction or reduction in blood supply, leading to decreased oxygen supply to the brain. This disease is the second leading cause of death worldwide and a leading cause of disability, including ankle disorders. Robot-Assisted Therapy (RAT) presents as a potentially effective ankle rehabilitation approach to improve walking and balance in stroke survivors. Unlike conventional ankle rehabilitation, RAT provides more repetitive and precise training. To address the gap in stroke rehabilitation, particularly in ankle function, this study was conducted to investigate the efficacy of various RATs in ankle rehabilitation in stroke patients. Methods: We conducted a literature search through PubMed, Scopus, Proquest, Sage, and EBSCOhost to assess RAT until August 12, 2024. The keywords used were (“Stroke” OR “Post-stroke” OR “Stroke rehabilitation”) AND “Robots” AND “Ankle” and their synonyms. Results: Five studies, with a total of 156 samples, were included in the qualitative and quantitative analyses. Meta-analysis showed that RAT ankle significantly improved walking speed with a Standardized Mean Difference (SMD) of 1.13 (95% CI: 0.32, 1.94; P = 0.006) and Active Range of Motion (AROM) with a SMD of 2.08 (95% CI: 1.5, 2.66; P < 0.00001). However, other parameters assessed in this study, namely the Berg Balance Scale (BBS) and Fugl-Meyer Assessment for Lower Extremities (FMA-LE), did not show significant effects in the intervention group compared to the control group. Conclusion: Robot-Assisted Therapy (RAT) shows promising potential to improve ankle rehabilitation in stroke patients. In addition, this study proves that RAT significantly improves walking speed and active ankle range of motion.
ANALYSIS OF INDONESIAN NATIONAL DATA FOR RELATIONSHIP BETWEEN PREVALENCE OF HYPERTENSION, PHYSICAL ACTIVITY, AND HIGH-RISK FOOD CONSUMPTION WITH STROKE PREVALENCE Haq, Nabiila Ala Qoonita Najma; Ernanda, Shelby Amrus; Marhaendraputro, Eko Arisetijono
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): 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

physical activity, and high-risk food consumption. This study aimed to analyze the relationship between these risk factors and stroke prevalence across Indonesia, using data from the Indonesian Health Survey covering 514 districts/cities in 38 provinces. The analysis focused on hypertension prevalence, physical activity levels, and dietary habits (particularly high salt intake). Spearman correlation results showed a significant association between hypertension and stroke prevalence (P < 0.001, r² = 0.451). In contrast, no significant association was found between low physical activity and stroke (P = 0.161, r² = 0.05), nor between high salt intake and stroke (P = 0.110, r² = 0.06). In conclusion, the study confirms that hypertension is significantly associated with an increased risk of stroke in Indonesia, emphasizing the need for interventions targeting hypertension to reduce stroke cases nationwide. While low physical activity and risky dietary habits did not show strong associations with stroke prevalence, these factors still warrant attention.

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