Case 10
Is It The Suicidal disease?
-A 46 years-old female, married
-For three years she complained of attacks of severe
headache, with a description of trigeminal distribution,
occasionally awakening her from sleep.
-She was diagnosed previously to have trigeminal
neuralgia syndrome, but no improvement to typical treatment.
-My impression of this case: this trigeminal pain was
not that typical of the classic trigeminal neuralgia (less intense,
stronger triggers). Note that classic trigeminal neuralgia is
called: suicidal disease, because of the agonizing pain triggered by
very mild stimuli, e.g. mild cold breeze.
-Proceeding with the case: A.N.A strongly positive with
a titre of 1/160, positive anti-Ds-DNA antibodies
-So, we considered this
attenuated trigeminal neuralgia to be caused by S.L.E.,
adding this presentation to the atypical presentations of S.L.E. we
have previously conducted in this clinical-rounds series:
- S.L.E. presented with
Guillain-Barré syndrome
- S.L.E. presented with
transverse myelitis
- S.L.E. presented with
loss of weight and bad general condition
- S.L.E. presented with attenuated trigeminal
neuralgia
-After initiation of
S.L.E. treatment the patient gave a marvelous response as regard
that agonizing, long-standing pain.
Consider this case with previously published
cases:
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