RESUMO
Herpes zoster is the consequence of reactivation of latent varicella zoster virus from dorsal root ganglia. Postherpetic neuralgia (PHN) may be diagnosed when pain persists in a dermatomal pattern long after the vesicular erruption has healed. PHN is a kind of neuropathic pain. The pathophysiology of PHN is uncertain, but neuropathic pain due to denervation supersensitivity may be important to understand the pathophysiology of PHN. Numerous treatment have been introduced for the management of PHN, but no methods that results in complete remission. Gunn's intramuscular stimulation (IMS) is one of the best treatment of chronic pain, especially neuropathic pain. We tried Gunn's IMS for treatment of PHN patients affecting thoracic dermatomes. As a result, the visual analogue scale (VAS) was decreased from 7-8 to 2-3 and the result were satisfactory. The purpose of this case report is to introduce the Gunn's IMS and review our experience for the treatment of PHN.
RESUMO
Frozen shoulder is characterized by pain in the shoulder and limitation of glenohumeral movement. The underlying pathologic changes in frozen shoulder are synovial inflammation with subsequent reactive capsular fibrosis. Capsular fibrosis is the ultimate course of frozen shoulder suffering from various causes irrespectively. Therefore, adhesions that are affecting the joint movement must be released. Most important diagnostic method is thoughtful history taking and physical examination, and ultrasonography is very valuable device of diagnosis and treatment. Interventional microadhesiolysis and nerve stimulation (IMNS) is effective to manage frozen shoulder patients. IMNS for frozen shoulder is composed of three release approaches. These are (1) subacromial, (2) posterior inferior capsular, and (3) subdeltoidal & subcoracoidal release and round needle can be used for each release. We report this experiences and recommand this technique for the treatment of frozen shoulder patients.
