Mr. This is a case of a 49 year old lady, Mrs. M.S. (Patient identification number: L-7732). She was suffering with Trigeminal neuralgia for the past 1year. The pain was felt on the left side of the face. Her pain used to start from the middle of the upper lip and extended to her left cheek and her left eye as well. She had this pain through out the day. This pain was initially once in 2-3 days. From July 2005 the frequency has increased and she used to have the pain on a daily basis. The pain used to last momentarily and was associated with numbness.

The pain experienced by her was like an electric shock and used to disturb her sleep. With the pain there was watering from her left eye (this is observed in regards to autonomic phenomena, lacrimation was most frequently present). Typically, autonomic phenomena occurred during the later stages of disease and during particularly severe and long-lasting attacks.

This pain was by consumption of hot drinks, when she ate anything, when she used to turn in bed. This pain was aggravated practically by every movement of the face. Not only this, but her pain was worse even when she brushed her teeth or even any kind of touch on her face.

She consulted a neurologist in January 2005 and she was out on T. Mazetol 200mg. She started with half tablet twice in a day. Until June 2005, she was a bit better but then beyond that there was no major change in her symptoms. As a result of this she followed up with her neurologist again. On her second visit her doctor added n a new tablet T. Gabantin 100 mg, 1 tablet e taken at bed time.

In spite of taking all these drugs still she was in pain. This pain disturbed her day to day routine activities which made her feel that she should be doing something else as well to get rid o this pain. By now her neurophysician had also increased her T. Gabantin dosage to three tablets in a day. It was at this point when she seeked homoeopathic treatment. This case therefore presented to us primarily as a challenge in management.

Associated complaints:
With all these complaints she also suffered with urticaria. She had the skin rashes with itching all over her body since the past 20 days. This episode was brought on by eating fish. She had a similar episode in April 2005 as well, but then she was treated with oral steroids at that time.

She was also a known hypertensive since the past 3 years. She was on antihypertensive drugs for the same.

Personal History:
She was an obese lady. Her appetite was diminished largely because of the pain which she was experiencing. Her sleep too was disturbed due to the pain. She had a remarkable craving for the sweets. She had profuse perspiration especially on her palms, soles and the armpits. Her sweat was offensive as well.

She was thermally very sensitive to hot environment. She was in the menopausal period but then her menses were very regular in the past.

Family history:
Her father and mother were known cases of hypertension and diabetes. Her brother was also a known diabetic. Her sister had complaints similar to IBS. Her maternal uncle passed away with brain hemorrhage. Her maternal uncle had oral cancer. Her other maternal uncle had leukemia (blood cancer). Her paternal aunt had hypertension and her he other paternal aunt had diabetes.

Social History:
She lived with her husband (who worked as a chief accountant in a firm), and her daughter was doing her further studies (MS in Biotechnology) in the US( Boston).

Previous operations:
She had a surgery for umbilical hernia around 7 years back.

Progress report:
Initially for a period of 6 weeks there was no appreciable improvement in her symptoms. After the 6 th week the improvement commenced and there was around 25% relief in her complaints. The pan which she used to have practically everyday used to now occur once in 8 to 10 days. This pain now used to be triggered by traveling as well by having a hair bath.

She also developed mild dry cough during the treatment. She was given appropriate homeopathic medicines and was better.

In the fourth month of the treatment there was around 50% relief in her complaints. The frequency of the pain was now once in 15 days. In the course of her continual improvement due to some unidentified triggering factors there was a relapse in her condition. This pain was worse when she used to cough. She even experienced heaviness as well as numbness above her lips. Her cough was aggravated during sleep and she even had cold for the past couple of days.

There were some necessary changes made in the line of treatment after which a new batch of medication was administered to her. With these medicines her condition again started responding very well. After a period of two months of uninterrupted treatment she was over 90% better. Now appreciating her betterment with Homoeopathy her neurophysician decided to taper the dosage of her T. Gabatin (100 mg) two tablets to be taken in place of 3 tablets which she used to require in the initial phases of the treatment.

Moreover, following on the similar lines of the treatment she is doing so well with the treatment that there is no pain whatsoever. There was only some numbness over her left ear. Her T. Gabatin dosage was tapered further and
she was taking only 1 tablet at night. She is advised to continue treatment in order to prevent the recurrence of the disease and also to maintain her good state of health.

Remarks:
The patient's own words: This story of my neuralgia relief seems impossible. And incredible as it seems, it's all true.