ABSTRACT
Objective To evaluate the effect of nerve root pulsed radiofrequency combined with neurotropin(NTP) by epidural injection for treating neuralgia in elderly patients with herpeszoster. Methods Sixty patients aged 60-85 years old with herpes zoster neuralgia were selected and divided into the observation group and control group. The control group was given the epidural injection of NTP,while the observation group was given the therapy of nerve root pulsed radiofrequency combined with NTP. Then the curative effects were observed in the two groups. The visual analogue scale (VSA) and Pittsburgh sleep quality index (PSQI) were used to evaluate the status of sleep improvement and the occurrence rate of post herpetic neuralgia (PHN) was also calculated. Results The VAS and PSQI scores at each time points of 1,3,6 months in the both groups were significantly superior to those before treatment (P<0.05). Compared with the control group,the VAS score at each time point after treatment in the observation group was significantly superior to that in the control group(P<0.05) ;The PHN occurrence rate after 6 months of treatment in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Nerve root pulsed radiofrequency combined with NTP by epidural injection is a good method for treating neuralgia in elderly patients with herpes zoster.
ABSTRACT
Herpes zoster represents the reactivation of latent varicella-zoster virus located in the dorsal root ganglion. The virus multiplies and migrates to the skin surface producing a characteristic, usually painful, pustular eruption. Severe pain during the acute phase of herpes zoster has been associated with a higher risk of developing postherpetic neuralgia. Sympathetic ganglion block and somatic nerve block have been used for patients in the acute phase of herpes zoster to alleviate pain and prevent postherpetic neuralgia. Sympathetic nerve block appears to achieve these goals by blocking the profound sympathetic stimulation that is a result of the viral inflammation of the nerve and ganglion. However, they require repeated local anesthetic injections to relieve the symptoms of acute herpes zoster as well as to prevent the occurrence of postherpetic neuralgia. Pulsed radiofrequency has been proposed as safe, nondestructive treatment method. We present a case of acute herpes zoster that was managed with pulsed radiofrequency treatment. The results were satisfactory.
Subject(s)
Humans , Autonomic Nerve Block , Ganglia, Spinal , Ganglia, Sympathetic , Ganglion Cysts , Herpes Zoster , Herpesvirus 3, Human , Inflammation , Nerve Block , Neuralgia, Postherpetic , Pulsed Radiofrequency Treatment , Skin , Stellate GanglionABSTRACT
OBJECTIVE: To assess the clinical manifestation of acute herpes zoster associated pain (AHP) and postherpetic neuralgia (PHN) and nerve block effect in AHP and PHN. METHOD: We assessed twenty eight patients by physical examination and pain questionairre, and nerve block effect in thirty one patients. We injected local anesthetics and triamcinolone into nerve root or trunk in study group, and saline in control group. The effect was assessed by visual analogue scale. RESULT: 1. Clinical manifestation: There was high incidence in thoracic dermatome. AHP and PHN patients expressed "sharp" pain. Pain rating index of AHP and PHN were 32.9, 33.0. 2. Nerve block effect: There was no nerve block effect in AHP (p>0.05) and PHN (p>0.05), but four patients of PHN patients in study group had significant pain relief, who suffered from pain during 2 month, 10 month, 6 years, 8 years. CONCLUSION: AHP and PHN had variable clinical manifestation but no difference between them. There was no nerve block effect in AHP and PHN but we can consider nerve block as a additive method for pain relief of PHN because some patients responded to nerve block and there was no significant complication in nerve block.