Although postherpetic neuralgia (PHN) is a common chronic pain syndrome, the pathophysiology of this disorder is not well known and management is often very difficult. N-Methyl-D-Aspartate (NMDA) receptor antagonists are known to be effective in PHN, and magnesium, a physiological blocker of NMDA receptors, is widely used to treat various chronic pain disorders. Here, we present a case of the PHN refractory to conventional treatment, which was treated successfully with transforaminal epidural injection of magnesium sulphate at the affected dermatome.
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http://dx.doi.org/10.3344/kjp.2011.24.1.53 | DOI Listing |
Am J Emerg Med
December 2024
University of California, Los Angeles - Department of Emergency Medicine, United States of America. Electronic address:
Introduction: The erector spinae plane block (ESPB) is a relatively new regional anesthetic procedure that provides analgesia below the erector spinae muscles in an interfascial plane. The indications for its use continue to expand as we learn more about this block.
Case: We report a case of a 60 year old woman presenting to the emergency department (ED) with severe intractable pain after recent onset of herpes zoster infection.
The literature in botulinum toxin treatment for painful diabetic neuropathy (PDN), post traumatic neuralgia (PTN), postherpetic neuralgia (PHN) and occipital neuralgia (ON) was reviewed up to Oct 1st 2024. Using the efficacy criteria set forth by the Assessment and Guideline subcommittee of the American Academy of Neurology, the current levels of efficacy for these conditions could be designated as followings: PDN: B (probably effective, two class II study), PTN: A (effective, two class I studies); PHN: A (effective, two class I studies), ON: (undetermined due to lack of blinded investigations). Due to the small number of patients in these studies, proof of efficacy requires conduction of controlled and blinded studies in large cohorts of patients with longer follow ups.
View Article and Find Full Text PDFCureus
December 2024
Pain Center, Kouseikai Takai Hospital, Tenri, JPN.
We report a case of a 65-year-old female with postherpetic itch (PHI) over the left chest, who experienced significant relief after pulsed radiofrequency (PRF) therapy. While her initial pain and rash had improved with nerve blocks and medications, she had developed severe itching. PRF therapy significantly reduced the itching, which nearly disappeared.
View Article and Find Full Text PDFCell Host Microbe
January 2025
Department of Biological Chemistry, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address:
Jiang et al. investigate the role of the microbiota in postherpetic neuralgia (PHN), a chronic pain condition resulting from varicella-zoster virus reactivation. They identify microbiome alterations in PHN patients, linking microbes and pain sensitivity.
View Article and Find Full Text PDFPhotobiomodul Photomed Laser Surg
January 2025
Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China.
Previous case reports hint ultraviolet A1 (UVA1) phototherapy as a novel adjunct treatment for acute cutaneous inflammations and neuralgia of herpes zoster, but its clinical effectiveness and safety in this condition are not yet proven by clinical trials. To determine the efficacy and safety of UVA1 phototherapy as an adjunct treatment for acute inflammation and neuralgia in herpes zoster. A total of 60 patients with moderate-to-severe acute herpes zoster were randomly divided into two parallel groups.
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