trigeminal neuralgia
Posted: Sun Nov 02, 2008 8:11 am
Hi,
Would appreciate some input on this case - the modalities are so clear
it should be easy, but I'm going round in circles with it.
50 y.o. Male - thin wiry build, eats a lot, very active, works hard,
takes on a lot of responsiblity in volunteer roles like sea scouts,
loves deepsea fishing. Family is very important, they do a lot together.
These episodes of right sided trigeminal neralgia have recurred annually
for the last few years in spring - weather here is very changeable,
going from the full heat of summer one day, right back to a wet cold
winter day the next. He says he can set his watch by the attacks -
9.10am exactly there will be one, but they come on at other times as
well.
They start with tingling across the scalp - his wife notices that he
will begin touching and rubbing his scalp. Then his right eye begins to
lachrymate profusely and his nose begins to run freely. Vision can
become blurred. Then the pain begins - it is so bad that no pain
medication touches it. He paces furiously, yells and screams with the
pain. His wife has taken him to the emercency room, not because they can
help (they never do), but because they are desperate, she fears he will
collapse and they don't know what else to do.
The only thing that helps (apart from pacing and screaming) is to run
scalding hot water over the right side of his head and face. Between the
attacks a lesser pain remains and he relies on strong medications - not
because they help, but because they might. He looks drawn and haggard -
but he keeps working as though nothing is wrong. During the period of
attacks he becomes averse to tea and starts drinking coffee.
When the attacks first began, Belladonna relieved the acute episode and
Kali Bich seemed to suit him constitutionally. After a couple of doses
of the Kali Bich I hadn't heard anything from him until this year. Now
he says he has had attacks annually since, gradually getting worse each
year. This year they are as bad as when they first began. The main
difference from the early attack is in that he now paces and screams.
When it first started he would stay very still and not move. I also
don't remember him using the scalding hot water last time or that there
was profuse watery discharge preceding the pain.
Gail.
Would appreciate some input on this case - the modalities are so clear
it should be easy, but I'm going round in circles with it.
50 y.o. Male - thin wiry build, eats a lot, very active, works hard,
takes on a lot of responsiblity in volunteer roles like sea scouts,
loves deepsea fishing. Family is very important, they do a lot together.
These episodes of right sided trigeminal neralgia have recurred annually
for the last few years in spring - weather here is very changeable,
going from the full heat of summer one day, right back to a wet cold
winter day the next. He says he can set his watch by the attacks -
9.10am exactly there will be one, but they come on at other times as
well.
They start with tingling across the scalp - his wife notices that he
will begin touching and rubbing his scalp. Then his right eye begins to
lachrymate profusely and his nose begins to run freely. Vision can
become blurred. Then the pain begins - it is so bad that no pain
medication touches it. He paces furiously, yells and screams with the
pain. His wife has taken him to the emercency room, not because they can
help (they never do), but because they are desperate, she fears he will
collapse and they don't know what else to do.
The only thing that helps (apart from pacing and screaming) is to run
scalding hot water over the right side of his head and face. Between the
attacks a lesser pain remains and he relies on strong medications - not
because they help, but because they might. He looks drawn and haggard -
but he keeps working as though nothing is wrong. During the period of
attacks he becomes averse to tea and starts drinking coffee.
When the attacks first began, Belladonna relieved the acute episode and
Kali Bich seemed to suit him constitutionally. After a couple of doses
of the Kali Bich I hadn't heard anything from him until this year. Now
he says he has had attacks annually since, gradually getting worse each
year. This year they are as bad as when they first began. The main
difference from the early attack is in that he now paces and screams.
When it first started he would stay very still and not move. I also
don't remember him using the scalding hot water last time or that there
was profuse watery discharge preceding the pain.
Gail.