No abstract available.
Neuralgia, Postherpetic*

No abstract available.
Neuralgia, Postherpetic*

Numerous treatment modalities for acute or subacute herpes zoster and postherpetic neuralgia have been introduced. Therefore, we updated the treatment modalities by conducting a wide review of the medical literature and we created a new treatment algorithm for herpes zoster and postherpetic neuralgia.
Herpes Zoster ; Neuralgia, Postherpetic

No abstract available.
Neuralgia, Postherpetic* ; Risk Factors*

BACKGROUND: The lidocaine patch has been effectively used as a first-line therapy to treat neuropathic pain such as postherpetic neuralgia (PHN). OBJECTIVE: To evaluate the safety and efficacy of the topical piroxicam patch as a treatment option for the treatment of PHN. METHODS: Eighteen patients completed a 3-session study, applying three different patches (lidocaine, piroxicam and control) in random order. A maximum of three patches were applied to the most painful area for three consecutive days (12 hours on followed by 12 hours off). Each session was conducted at least seven days apart. The changes in visual analog scale (VAS) scores based pain intensity, quality of sleep and adverse effects were recorded. RESULTS: When compared to the control, both the lidocaine and piroxicam patches significantly reduced the mean VAS scores of pain intensity of all different types. However, the lidocaine patch was better at reducing allodynia, whereas the piroxicam patch was more effective for dull pain. The lidocaine patch worked faster than the piroxicam patch for the response to overall pain relief. CONCLUSION: The results of this study suggest the use of the piroxicam patch for dull pain and in patients where the lidocaine patch is contraindicated.
Humans ; Hyperalgesia ; Lidocaine ; Neuralgia ; Neuralgia, Postherpetic ; Piroxicam

BACKGROUND: Postherpetic neuralgia is usually defined as pain persisting for more than one month after the onset of the eruption of herpes zoster, although there is a overlap between this and the pain of the acute zoster. Many approaches have been proposed to treat postherpetic neuralgia, however, it remains a source of frustration for both patients and physicians. OBJECTIVE: The purpose of this study was to determine more precisely the relationship between the effects of continuous epidural blockade and the time of treatment on postherpetic neuralgia. METHODS: We analyzed the results of 5 patients with postherpetic neuralgia for whom continuous epidural blockade was performed within 1 month after the onset of postherpetic neuralgia, and compared them with the results of 5 patients for whom continuous epidural blockade was performed after 1 month after the onset of postherpetic neuralgia. RESULTS: Continuous epidural blockade performed within 1 month after the onset of postherpetic neuralgia reduced pain significantly, compared to the results of continuous epidural blockade performed after 1 month after the onset of postherpetic neuralgia. CONCLUSION: Continuous epidural blockade performed within 1 month after the onset of postherpetic neuralgia may be the treatment of choice for the pain.
Frustration ; Herpes Zoster ; Humans ; Neuralgia, Postherpetic*

Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster, especially in elderly and comorbid patients. Unfortunately, the currently available treatments have shown limited efficacy and some adverse events that are poorly tolerated in elderly patients. Scrambler Therapy, proposed as an alternative treatment for chronic neuropathic pain recently, is a noninvasive approach to relieve pain by changing pain perception at the brain level. Here, we report our clinical experiences on the effect of Scrambler Therapy for three patients with PHN refractory to conventional treatment.
Aged ; Brain ; Herpes Zoster ; Humans ; Neuralgia ; Neuralgia, Postherpetic ; Pain Perception

BACKGROUND: Herpes zoster is a significant and troublesome disease. The pain of acute herpes zoster may be severe, but is usually transitory. Some patients, especially the elderly at particular risk, go on to develop neuralgia. Unfortunately, neuralgia is often severe and refractory to most forms of treatment. The purpose of this study was to estimate improved rates of neuralgia according to associated factors. METHODS: We observed the improved rates of neuralgia in 123 patients who had herpes zoster with severe pain and treated with antiviral therapy after admission. Also, we compared them by age group, dermatomal distribution, and initiating day of antiviral therapy. RESULTS: At 4 weeks of treatment, the improved rates of neuralgia according to age younger group was high and older group was low. The improved rates of neuralgia according to the starting day of treatment was high 100% in 1 day, 76.5% in 2, 65.0% in 3days, and 18.2% in 7 days after skin eruption. CONCLUSION: In herpes zoster with severe pain, age and initiation of antiviral therapy are significant predictors of neuralgia.
Aged ; Herpes Zoster* ; Humans ; Neuralgia ; Neuralgia, Postherpetic* ; Skin

Tricyclic antidepressant (TCA) is a useful drug for treating neuropathic pain. However, tremors are one of the relatively frequent side effects of TCA. A female patient, who was suffering from postherpetic neuralgia, was treated with amitriptyline starting with 10 mg/day. She developed resting tremors on the second day after increasing the dose to 30 mg/day. This case highlights the need for the careful use of amitriptyline in the treatment of neuropathic pain in elderly patients.
Aged ; Amitriptyline ; Female ; Humans ; Neuralgia ; Neuralgia, Postherpetic ; Tremor*

Pulsed radiofrequency treatment has an analgesic effect by neuromodulation of the central pain pathway without neural injury. However, lack of knowledge regarding the exact mechanism on neuropathic pain makes the use of pulsed radiofrequency treatment controversial. Here, we describe a case of satisfactory pain relief after ultrasound-guided pulsed radiofrequency treatment in a patient with supraorbital herpetic pain refractory to medication. This case indicates the potential of ultrasound-guided pulsed radiofrequency treatment in patients with postherpetic supraorbital neuralgia.
Humans ; Neuralgia ; Neuralgia, Postherpetic* ; Pulsed Radiofrequency Treatment* ; Ultrasonography