Homoeopathy Shoots the Shooting Pain

[A Case of Trigeminal Neuralgia treated at Ber sarai Dispensary]

Dr Pawan Goel, Chief Medical Officer(H), Ber Sarai Dispensary

drpawangoel@yahoo.co.in
ABSTRACT
Trigeminal neuralgia is rare but one of the most annoying medical condition affecting mostly
people of 50 years of age and above presenting with severe facial pain ,needs medical and
surgical intervention depending upon the case.A diagnosed case of TN treated at Ber Sarai
Dispensary with Homoeopathic remedy Natrum Mur in span of approx one year the
frequency and intensity of the neuralgic pains reduces drastically ,with overall improvement
in general condition of patient.
KEY WORDS
Trigeminal neuralgia,natrum mur ,homoeopathy,syphilitic miasm,
INTRODUCTION
Trigeminal neuralgia a neuropathic disorder illustrated by episodes(periodic or non periodic)
of intense pain in the face. The clinical association between TN and hemifacial spasm is the
so-called tic douloureux.
The pain generally felt in the ear, eye, lips, nose, scalp, forehead, cheeks, teeth, or jaw and
side of the face.
DEMOGRAPHY
TN is a rare disease. TN occurs most often in people over age 50, and the average for
women is slightly higher than for men.
TRIGEMINAL NERVE AND ITS TRIBUTARIES CLINICAL CORRELATION
The pain of TN is from the trigeminal nerve. The trigeminal nerve is a paired cranial
nerve that has three major branches:
the ophthalmic nerve (V1),
the maxillary nerve (V2),
the mandibular nerve (V3)
. One, two, or all three branches of the nerve may be affected. 1012% of cases occur on
both sides of the face. Trigeminal neuralgia most commonly involves the middle branch
(the maxillary nerve or V2) and lower branch (mandibular nerve or V3) of the trigeminal nerve.
ETIOLOGY
1. Pressure exerted by the underlying blood vessel on the trigeminal nerve and the
tributaries
2. Mechanical damage to the nerve by dental procedure,infections
3. Over time, changes in the blood vessels of the brain can result in blood vessels rubbing

against the Trigeminal Nerve Root.

4. Aging leading to the demyelination of the nerve ,multiple sclerosis.
5. Rarely present with the tumour of the nerve
GRADATION OF PRESENTATION
S NO
1
2
3
4

TN1
typical or classic form
extreme, sporadic, sudden burning or shock-like
facial pain in the areas of the face where the
branches of the nerve are distributed lips, eyes,
nose, scalp, forehead, upper jaw, and lower jaw.
Higher intensity
These attacks can occur in quick succession, in
volleys lasting as long as two hours

TN2
atypical form
aching, burning, stabbing
pain
Lower intensity
Lesser duration

Both forms of pain may occur in the same person, sometimes at the same time.
CLINICAL PICTURE
Trigeminal neuralgia symptoms may include one or more of these patterns:
1. Episodes of severe, shooting facial pain that may feel like an electric shock
2. continuous attacks of facial pain or attacks triggered by things such as touching the face,
chewing, speaking and brushing teeth
3.episodes of facial pain lasting from a few seconds to several seconds
4. Episodes of several attacks lasting days, weeks, months or longer some people have
periods when they experience no pain
5. Pain in areas supplied by the trigeminal nerve (nerve branches), including the cheek, jaw,
teeth, gums, lips, or less often the eye and forehead
6. Pain affecting only one side of face.
7. Pain focused in one spot or spread in a wider pattern
8. Attacks becoming more frequent and intense over time
TRIGGERS OF TRIGEMINAL NEURALGIA
A variety of triggers may set off the pain of trigeminal neuralgia, including:
-- Shaving
---Touching face
--- Having food
--- Drinking
--- Brushing your teeth
---. Talking
--- Putting on makeup
--- Facing breeze directly on face
----Smiling

DIAGNOSIS

TN diagnosis is based primarily on the persons history and pattern of symptoms description
of pain, including the:
1. Type. Pain related to trigeminal neuralgia is sudden, shock-like and brief.
2. Location. The parts of face that are affected will tell the doctor if the trigeminal nerve is
involved., along with results from physical and neurological examinations.
Tests used to confirm the diagnosis
1. A neurological examination. Touching and examining parts of face can help the doctor
determine exactly where the pain is occurring and if appear to have trigeminal neuralgia
which branches of the trigeminal nerve may be affected.
2. Magnetic resonance imaging (MRI). An MRI scan of your head can show if multiple
sclerosis is causing trigeminal neuralgia.
TRIGEMINAL NEURALGIA TREATMENT
trigeminal neuralgia treatment generally starts with suitable medications and general
managements includes the maximum possible avoidance of triggering factors
Interventions are required at:Status quo with medication, Side effects of medications
,Finding of life threatening underlying pathology like tumors

Case at Ber Sarai Homoeopathic Dispensary

I present a case of trigeminal neuralgia that defines the need of rational integration of
ayush (homoeopathy in this case) with modern system of medicines so that patient is
ultimately benefitted of her sufferings .
Mrs usha age 65yrs resident of saket visited ber sarai homoeopathic dispensary in middle of
september 2014 for her sufferings of trigeminal neuralgia after getting treatment from AIIMS
in medicine as well as in the dept of neurosurgery.
The presenting complaints were severe shooting pain radiates from lower end of left ear to
the jaw and settle in the teeth,along the left side of face much tingling and burning with
excessive lacrimation ,Facial pain worse by touch with intolerance of heat and chewing
.Headache in the morn that persists whole day with slight relief in even after sleep .
Observation: woman of medium build with earthy complexion, waxy anxious face
Past history and family history NS
Treatment history Oxydol 300 mg tds from AIIMS med opd with no relief ,Gamma knife at
vimhans, Surgery at AIIMS :decompression of trigeminal loop (L) done .
Generals
Appetite: increased ravenous ,relish food sometime without appetite
Thirst: increased for large quantities of water
Desire foods having large quantities of salt
Aversion bread fatty food
Sleep sleepy in noon with relief of headache after short bouts of sleep

Sweat on slight exertion with occasional yellow staining

Thermal reaction cannot tolerate heat feels better walking in fresh air.

Mind and thinking patient was very much anxious of her health and she was doubtful of her
recovery,excessive thinking of her disease made her worse ,consolation aggravates her in
general
Analysis:
Case on the basis of symptomatology suggested anti syphilitic remedy for the treatment .

Rubrics taken for reference purpose from synthesis repertory like

Hypochondrisis ( so marked in patient that sometime she used to said pl doc give her
something for sos and her friend is taking bell and cimicifuga so I have to write for her
satisfaction and eventually gave saclac )
consolation agg
face pain stitching left side
shooting left side
from perspiration :weakness
Prescription and Follow Up

S NO

DATE

19/9/2014

SYMTOMATOLOGY/
BASIS OF
PRESCRIPTION

FOLLOW UP
I-INTENSITYOF
PAIN
F-FREQUENCY OF
PAIN
A-ALLOPATHIC
DOSAGE

Left Sided Trigeminal

Neuralgia With
Shooting Pain
Lacrimation
Aggravation Touch
Chewing
Heat Intolerance
Headache Agg Morn
Relieved By Sleep

RX

Nat Mur 30 Td S
For 4 Days
Sl 30 For 2 Wks

Earthy Complexion Oily

As If
Greased
2

23/9/2014

I -SAME
F -REDUCED BY
30-40%
A OXYTOL 300

SL 30 TDS FOR 1
MONTH

ADV TO REDUCED
FROM TDS TO OD
AMLONG 25OD TO
CONTINUE
3

25/10/2015 Headache Better

Lacrimation Stopped

31/1/2015

I- SAME
F-REDUCED BY 70
% APPROX
A-SAME AS ABOVE

Headache Reappear
Neuralgic Pain Same As
In Beginning
Detailed Case With
Mentals And Physical
Gen

Nat mur 200

3 doses empty
stomach
Adv To Stop
Allopathic Med
And Suggested
For Follow Up In
Case Of Severe
Complications

Prescribed On The
Totality Of Symptoms
5

28/2/2015

7/4/2015

GC BETTER

6/6/2015

Symptoms Subsides
Completely

SL 30 TDS FOR 6
WKS

I REDUCED
F REDUCED BY
80%
A- STOPPED
I- REDUCED BY
80%
F- REDUCED BY
MORE THAN 80%
A-STOPPED
INTENSITY AND
FREQUENCY OF
PAIN REDUCED
DRASTICALLY

SL 30 BD FOR 1
MONTH

SL 30 OD FOR 6
WKS

Result and conclusion:

Patient was suffering from trigeminal neuralgia on account of loop formation along the
course of trigeminal nerve. Surgery was done for decompression and allopathic medicines
were prescribed to patient .
Symptoms in response to triggering factors were persistent even after surgery and with
modern medicine .Homoeopathic medicine was prescribed on the basis of totality of the
case considering the character of the pain and general features .There is much reduction in
the intensity and frequency of the episodes of neuralgic pain and reduction in the dosage of
allopathic drugs thus reducing the drug dependency defining the need of rational integration
of modern medicine and procedure with the AYUSH (homoeopathic in this case) for the
service of mankind as in this case obstacle to recovery was removed by surgery ,acute
phase was covered by allopathic medicines and with aid of homoeopathic medicines
allopathic medicines were tapered off.

References:

http://www.livewellpainclinic.com/trigeminal_neuralgia.aspx
https://en.wikipedia.org/wiki/Trigeminal_neuralgia
http://fpa-support.org/trigeminal-neuralgia
William boericke ,pocket manual of homoeopathic material medica &repertory,B Jain
publisher(p) LTD ,9 th edition
Dr Frederik Schroyens ,Synthesis repertory ,homoeopathic publishers London ,edition 7.1

Annexure: