Post-herpetic neuralgia (PHN) is chronic neuropathic pain that is felt for at least 3 months or more at the site of the rash due to herpes zoster infection. Epidemiological studies get a prevalence of 0.49 cases of PHN per 1000 people per year. The clinical manifestation of PHN is chronic pain on the skin lesions due to herpes zoster infection. The therapy that is commonly used as the first line is the provision of pharmacotherapy such as gabapentin or pregabalin. An 83-year-old male patient with a diagnosis of PHN that had been felt for 5 years. He has been taking drugs for 5 years but the pain has not improved. The patient is given high-intensity laser therapy. After 5 treatments with an interval of 1-2 weeks, pain was significantly reduced from an 8/10 scale to 4/10. The frequency of occurrence of severe pain is also reduced from 5 times per day to only 1 time per day. The use of high-intensity laser therapy is not commonly used as a therapy for PHN. Based on its mechanism of action, the use of high-intensity laser therapy is worth considering because of its effectiveness in treating pain in a shorter time than low-intensity laser therapy.

Background: Ischemic stroke account for about 87% of all stroke cases. This study will focus on ischemic stroke due to small vessel occlusion as one of the subtypes based on TOAST (trial of ORG 10172 in acute stroke treatment). Objective: To determine the characteristics of ischemic stroke patients caused by small vessel occlusion and are expected to be used as a basis for further research. Methods: A descriptive observational retrospective study regarding the characteristics of acute ischemic stroke patients due to small vessel occlusion at Sanglah Hospital. Secondary data were obtained from patient medical records. Results: The total number of cases of small vessel occlusion was 338. The majority of the sample were men (64.5%) between 40-60 years old (53.6%). Most of the samples were patients who had experienced an ischemic stroke for the first time (75.1%) with NIHSS (National Institute of Health Stroke Scale) scores showing mild (48.2%) and moderate (51.5%) symptoms. Around half of them had a history of hypertension (60.1%), dyslipidemia (59.5%), and diabetes mellitus (44.1%). The most common location of infarction was in the anterior circulation (77.5%) with almost the same ratio of right and left hemisphere locations. Conclusion: Ischemic stroke due to occlusion of small vessels at Sanglah Hospital Denpasar for 3 years was 35.2% of the total ischemic stroke cases. Half of the total sample had classic vascular risk factors. Further research is needed to determine another effective treatment strategy other than just secondary prevention such as life style moderation to prevent recurrency.

Charcot-Marie-Tooth (CMT) or Hereditary Motor and Sensory Neuropathy (HMSN) is the most common hereditary peripheral nerve disease with progressive chronic weakness, muscle atrophy, and sensory disturbances. There are several types and subtypes of CMT with their respective clinical manifestations. In this article, we reported a patient with of CMT type X. A 43-year-old male patient was referred to a neurology clinic with weakness in both limbs for 2 years, accompanied by tingling and sensory disturbance in both hands and feet. There are several of his family members who had similar complaints. Lumbosacral magnetic resonance imaging (MRI) examination revealed mild nucleus pulposus herniation. Electroneuromyography (ENMG) examination revealed demyelinating sensory motor polyneuropathy. Histopathological examination of nerve biopsy showed demyelination of the sural nerve. It is hard to make a diagnosis of CMT, because it requires high suspicion from clinicians once encounter a suspected case and also need to supported by sophisticated equipment such as electrophysiological examinations, nerve biopsy examinations, and genetic examinations. It is vital for clinicians for being able to diagnose CMT correctly and provide treatment as soon as possible in order to maintain the patients’ quality of life.

Cognitive function has a significant impact on individuals’ quality of life. Over time, human cognitive function tends to decline. The importance of cognitive function in everyday life has led many researchers to seek alternative treatments to maintain and improve cognitive function. Some studies show that curcumin can improve cognitive function and prevent cognitive decline in humans.  This review focuses on the benefits of curcumin on cognitive function and the mechanism of how it works from molecular aspect. According to some studies, one of the factors leading to cognitive decline is chronic low-grade systemic inflammation. This review will focus on antioxidant, anti-inflammatory, neuroprotective effects, and β amyloid aggregation inhibition properties of curcumin that can improve cognitive function or delay cognitive decline. It is important to understand the basic reasons why curcumin can have benefits on cognitive function, this can be seen from the mechanisms that are reflected in the biomolecular aspect.

Penyakit huntington merupakan penyakit herediter autosomal dominan yang sangat jarang ditemui di Indonesia. Penyakit ini memiliki ciri khas gangguan gerak involunter berupa korea yang memberat dari distal ke proksimal. Pasien penyakit huntington juga biasanya memiliki gangguan fungsi kognitif dan gangguan psikiatri. Diagnosis didapatkan dari pemeriksaan klinis, riwayat keluarga, dan ditegakan dengan pemeriksaan genetik dimana didapatkan mutasi gen HTT yang mengkode pengulangan trinukleotida CAG lebih dari 35 kali sehingga menghasilkan protein toksik bernama huntingtin. Sampai saat ini penyakit huntington belum memiliki regimen terapi yang dapat menyembuhkan ataupun memperlambat progresivitasnya. Pasien hanya akan memperoleh terapi simtomatik yang bertujuan untuk mempertahankan kualitas hidup. Pasien huntington memiliki prognosis yang buruk dengan rata-rata kematian terjadi 17-20 tahun pasca munculnya onset gejala.               Artikel ini melaporkan seorang pasien perempuan 76 tahun warga negara Indonesia yang memiliki gejala korea dan gangguan fungsi kognitif dengan onset 10-15 tahun yang lalu. Pasien memiliki ibu, adik, dan juga anak yang juga memiliki gejala serupa. Pasien dicurigai memiliki penyakit huntington, namun tidak dapat ditegakan karena tidak dilakukan pemeriksaan genetik. Pasien tidak menerima terapi dalam bentuk apapun untuk penyakitnya.