• The Korean Journal of Pain
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• 제26권2호
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• pp.195-198
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• 2013

Herpes zoster is a cutaneous infection that is characterized by an acute vesicobullous rash with ipsilateral one or two dermatomal distribution and painful allodynia, while predominantly being found in the elderly. Extensive cutaneous dissemination has been reported in immune-compromised patients, such as those who suffer from HIV infections, cancer, chemotherapy, and corticosteroid therapy patients. However, we report a case of disseminated herpes zoster infection in an immuno-competent elderly individual.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.52-56
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• 2005

Herpes zoster (HZ) is an acute infection of the unilateral sensory dermatome caused by varicella-zoster virus (VZV) and is characterized by vesicular eruption and unilateral pain along the involved dermatome. Although the pathogenesis of HZ is incompletely understood, it is thought that when cell-mediated immunity falls below a critical level, dormant VZV within cells of the sensory ganglia are allowed to replicate and infect the host with the resultant clinical presentation of HZ. It has been associated with immunosuppressed states, such as advanced age, leukemia, lymphoma, chemotherapy and/or radiation treatment. We present a case of a 62-year-old female patient with malignant lymphoma suffering herpes zoster ophthalmicus who did not respond to conventional treatment, and in whom the application of various nerve blocks and patient-controlled analgesia produced moderate pain relief. The patient died twenty days later due to cardiopulmonary failure.

• 대한후두음성언어의학회지
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• 제16권1호
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• pp.81-84
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• 2005

Vagus nerve palsy caused by herpes virus infection is rare. Here, the author presents a 65-year-old woman with acute onset of right side otalgia and sore throat, followed by delayed vocal fold paralysis on the same side. Vesicles were also found on the posterior wall of ear canal but the tympanic membrane was not involved. Laryngoscopy revealed multiple ulcerative lesions on the pharyngeal and laryngeal mucosa exclusively on the right side. One month later, she noticed dyshonia which turned out right vocal fold paralysis. Skull base to upper chest CT did not reveal local lesion. Three months after finishing the acyclovir, her symptoms were almost gone and vocal fold movement has almost completely improved. Vagus nerve involvement of herpes infection should be considered as a differential diagnosis for patients with herpes zoster oticus with sore throat.

• Journal of Oral Medicine and Pain
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• 제35권1호
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• pp.93-99
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• 2010

대상포진(Herpes Zoster:HZ)은 수두 대상포진 바이러스(Varicella Zoster virus)에 의해 야기된 속발성 또는 잠복성 감염이다. 증령에 따라 바이러스 특이적 면역 및 세포 매개 면역력이 감소하면서 바이러스가 재활성화되기 때문에, 대상포진은 주로 노년층에서 호발한다. 대상포진에 이환되면, 극심한 급성 통증이 발생하게 되고 수개월에 걸쳐서 회복하게 된다. 포진후신경통(Postherpetic neuralgia:PNH)은 대상포진의 대표적인 합병증의 하나로, 대상포진에 이환된 후 발생한 통증이 3개월 이상 회복되지 않을 때, 포진후신경통으로 진단할 수 있다. 임상적 증상으로는 주기적으로 찌르는 듯한 통증이 동반되는 타는 듯한 통증, 이질통이 발생할 수 있으며, 감각저하 또는 지각이상을 보일 수 있다. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.)는 신경의 감각이상을 평가하는 데 유용하게 쓰이는 평가기구이다. 이번 증례는 포진후신경통을 주소로 내원한 환자의 치료 증례를 통해, 포진후신경통의 발생기전을 고찰해보고, 그 치료법에 대하여 알아보고, 또한 치료과정 중의 경과관찰 방법으로서 $Neurometer^{(R)}$를 이용하여, 감각이상의 평가 및 경과관찰시 지각이상에 대한 정량적인 평가를 시도하였다.

• 대한한방내과학회지
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• 제39권2호
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• pp.159-164
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• 2018

A case of a 72-year-old Korean male with herpes zoster ophthalmicus revealed. He was treated with Korean-Western cooperative treatment. We used the Numeric Rating Scale (NRS) to evaluate forehead and eye pain. Pain was improved after the administration of Korean medical treatments and disappeared after eight days. Korean-Western cooperative treatment may be effective in treating acute herpes zoster ophthalmicus.

• 한방안이비인후피부과학회지
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• 제36권4호
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• pp.187-195
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• 2023

Objectives : The aim of this study is to report the effect of Korean-western combination treatment in two patients with Herpes Zoster. Methods : During hospitalization, two patients were treated with Galgeunkilkyung-tang, acupucture, pharmacopuncture, antiviral agents, painkiller. To evaluate the effect of this treatment, we used Numeric Ration Scale(NRS) and Quality of Sleep(QSP). Results : After treatment, NRS and QSP of 2 patients were improved remarkably. Conclusions : According to the result, these finding suggest that Korean-western combination treatment can be effective for the treatment of herpes zoster.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.31-33
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• 2005

Segmental zoster paresis (SZP) is a clinically rare complication of herpes zoster. But it has not been reported that acute cerebral motor cortical infarction coincidentally occurred in SZP. A 86-year-old woman was admitted due to pain, tingling sensation, and weakness of left arm. She had an acute onset of pain and tingling sensation in left arm at first day, shoulder weakness at second day, and multifocal vesicles at fourth day. Deep tendon reflexes of left arm were decreased than right. Electromyography showed an axonal polyneuropathy at superior trunk level of left brachial plexus. Median and ulnar sensory evoked potential tests were normal. Brain MRI showed a high signal in right primary motor cortex on diffusion weighted image. We report a case of acute cerebral motor cortical infarction coincidentally occurred in SZP.

• The Korean Journal of Pain
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• 제37권4호
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• pp.343-353
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• 2024

Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC₃₀ was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions: Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.

• Clinical and Experimental Pediatrics
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• 제52권6호
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• pp.705-709
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• 2009

대상포진은 흔한 질환으로 여러 가지 합병증을 동반 할 수 있으나 대상포진에 동반되어 수막염이 생긴 경우는 보고는 많지 않다. 저자들은 15개월에 수두 예방접종을 시행 받았고, 5세 때 수두를 앓은 과거력이 있던 건강한 14세 남자 환아에서 대상포진에 동반되어 급성 무균성 수막염이 발생한 증례에서 뇌척수액에서 중합효소연쇄반응을 통해 VZV DNA를 검출한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.210-213
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• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.