Shrinking of Allodynia Area by Surrounding Acupuncture with Electroacupuncture in Two Cases of Postherpetic Neuralgia: A Case Report
- VernacularTitle:鍼通電療法により帯状疱疹後神経痛に伴う アロディニア領域の縮小を認めた2症例
- Author:
Masaki MURAHASHI
1
;
Shintaro IBATA
1
;
Go HORIBE
1
;
Ai KOUCHI
1
;
Satoru YAMAGUCHI
1
Author Information
- Keywords: Acupuncture; Surrounding needling; Electro-acupuncture; Postherpetic neuralgia; Allodynia
- From:Journal of the Japan Society of Acupuncture and Moxibustion 2023;73(4):259-268
- CountryJapan
- Language:Japanese
- Abstract: [Objective] Postherpetic neuralgia (PHN) is commonly associated with allodynia in around 90% of patients, which is related to both physical and psychosocial distress. In this report, we report two cases in which surrounding needling with electroacupuncture (EA) at 2Hz was performed for allodynia in the thorax and upper limb, resulting in a reduction of the allodynic area. [Case 1] A 67-year-old male with right-sided anterior thoracic pain. He experienced the initial symptoms in December of a certain year and was diagnosed with herpes zoster the following day. Despite receiving antiviral medication, the pain persisted, leading to a referral to our Saitama Medical University in June of the following year. [Case 2] An 80-year-old female complained of left upper limb pain because of herpes zoster following chemotherapy for multiple myeloma in February of a certain year. In September of the same year, she was referred to our department due to persistent pain and allodynia, despite receiving analgesic medication for PHN since June. [Evaluation] The allodynic areas were calculated as the ratio of the allodynic area to the total area of the anterior thorax and upper limb using Image J. Pain intensity was assessed using the Visual Analogue Scale (VAS). [Treatment] We applied surrounding needling with electro-acupuncture for two cases. Acupuncture needles in the specification of 0.18 × 50 mm (Seirin Co., Ltd, Japan) were inserted transversely as like surrounding the allodynic region and connected to the EA apparatus (Zeniryou Co., Ltd, Japan). EA parameter was selected as dilatational wave. [Time course 1] The ratio of allodynic area was 20.0% at the first session, with a VAS of 28mm. After 8 months, the ratio decreased to 1.7%, and the VAS reduced to 18mm. The analgesics that were being taken at the first session were discontinued by the end of the session. [Time course 2] The ratio of allodynic area was 66.1%, with a VAS of 82mm at the first session. After 6 months, the ratio decreased to 24.1%, and the VAS reduced to 48mm. The analgesics were unchanged, while there was a reduction in the rescue medication. [Discussion] In two cases of intractable PHN with allodynia, EA reduced pain intensity and improved quality of life, with Image J serving as a useful assessment tool. [Conclusion] Surrounding needling with EA at 2Hz may be effective for two cases of PHN with allodynia.
