ABSTRACT
Acute herpes zoster (AHZ) causes postherpetic neuralgia (PHN) in 48-75% of patients. Nerve blocks performed in the acute phase of HZ may treat the pain and prevent PHN development. Here, we present pain relief with modified van-Lint block in two cases with AHZ involving vesicles on the traces of the supraorbital and supratrochlear nerves. Two female patients, 72 and 66 years old, with AHZ involving vesicles on the traces of the supraorbital and supratrochlear nerves starting from the right periocular region to the scalp presented with symptoms such as hypoesthesia, dizziness, burning, throbbing, and severe pain. Their initial visual analogue scale (VAS) scores for pain were 9 and 10, respectively. Supraorbital and supratrochlear nerve blockade with modified van-Lint technique was planned, as the classical nerve block sites were covered with active vesicles. Following the nerve blocks, VAS scores of both patients decreased to 1 immediately. Vesicles were faded and scabbed, symptoms such as hypoesthesia, burning and throbbing had recovered, dizziness was relieved, and VAS scores were 4 and 5, respectively, after one week. VAS scores were 1 and 2, respectively, after the second injection, and all symptoms were resolved, and no additional analgesic was required during a three-month follow-up. Modified van-Lint block with 5 mL 1% lidocaine may provide successful pain relief in AHZ involving vesicles on the traces of the supraorbital and supratrochlear nerves.
