• 제목/요약/키워드: Pain: postherpetic neuralgia

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Recombinant zoster vaccine (Shingrix®): a new option for the prevention of herpes zoster and postherpetic neuralgia

  • Singh, Grisuna;Song, Sejin;Choi, Eunjoo;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • 제33권3호
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    • pp.201-207
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    • 2020
  • Postherpetic neuralgia (PHN) is a challenging condition for pain management specialists. The prevention of herpes zoster (HZ) and subsequent PHN in individuals aged 50 years and older, via the development of new vaccines, is an ongoing research project. The live zoster vaccine (LZV, Zostavax®) was the first proof of concept that vaccination could prevent HZ, but LZV cannot be used in various immunecompromised patients. This led to the development of a new non-live recombinant zoster vaccine (RZV, Shingrix®). This RZV has shown promising results in many clinical trials, with high reactogenicity and similar systemic adverse effects compared to those of LZV. The National Advisory Committee on Immunization has recommended LZV as a standard vaccine for HZ prevention in adults ≥ 50 years of age, but no studies directly comparing the safety and efficacy of RZV and LZV vaccines have been conducted. This article reviews the brief history, efficacy, and safety of the two vaccines and discusses the advantage of RZV over LZV based on the available literature.

소음인 보중익기탕 가감방 투여를 포함한 대상포진 후 신경통 환자 한방복합치료 1례 (A Case of Postherpetic Neuralgia Treated with Korean Medicine, including Soeumin Bojungikgitang-gagambang)

  • 김나영;김태주;권민진;임유라;이동환
    • 대한한방내과학회지
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    • 제44권5호
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    • pp.920-928
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    • 2023
  • Objectives: This study reports on the effect of Korean medicine treatment, including Soeumin Bojungikgitang-gagambang, on a patient with postherpetic neuralgia. Methods: The patient received Korean herbal medicine, pharmacopuncture treatment, and acupuncture treatment for 22 days. We assessed changes in symptoms due to the treatment using the Numeric Rating Scale (NRS), the McGill Pain Questionnaire-Short Form (SF-MPQ), and the European Quality of Life-5 Dimensions (EQ-5D) scale. We also measured the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) to distinguish neuropathic pain. Results: After treatment, the patient showed decreased NRS, SF-MPQ, and EQ-5D scores. Conclusion: The results indicate that Korean medicine treatment, including Soeumin Bojungikgitang-gagambang, is an effective management of symptoms in patients with postherpetic neuralgia.

대상포진 환자 치험 1례 (A Case Report on Herpes Zoster)

  • 김미랑;서운교;신정인
    • 대한한방내과학회지
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    • 제23권1호
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    • pp.147-152
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    • 2002
  • Clinical symptoms of herpes zoster include red rash, burning pain, tingling or extreme sensitivity in the affected area, usually limited to one side of the body. There might be a fever or a headache. The pain of acute herpes zoster may be severe, but it is usually temporary. Some of old patients are likely to develop postherpetic neuralgia. We treated a 73 year-old male patient who had severe pain and a headache after acute herpes zoster. In the point of Differentiation of Syndromes(辯證), this subject was diasgnosed as wind-heat syndrome(風熱證) and was administered Bangpungtongsung-san. For the purpose of making the pain easier, we used the western medication as well. After six days of treatment, pain and the other symptoms improved. Besides postherpetic neuralgia dissipated. Based on this experience, both oriental medicine and western medicine have a good effect on acute herpes zoster.

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대상포진후신경통에 관한 인터넷 사이트 평가 (Assessment of the Quality of Postherpetic Neuralgia Related Korean Internet Sites)

  • 이재학;박상규;이두익;정종권;임현경;차영덕
    • The Korean Journal of Pain
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    • 제22권2호
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    • pp.141-145
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    • 2009
  • Background: There is no assessment of internet sites that carry information on chronic pain disease. So we assessed the quality of information about postherpetic neuralgia available on Korean internet sites. Methods: The keywords 'postherpetic neuralgia', 'herpes zoster, neuropathic pain', 'herpes zoster, pain', 'herpes zoster' were searched in Korean on four search engines in Korea between the 1st to the 15th of May, 2009. We evaluated the outcome on two factors; the aspect of the contents which is subdivided into two categories, the content and authorship, and the technical aspect including web design, and efficiency. Results: A total of 26 internet sites were found. Among these sites, 6 (23%) informed by anesthesiologist. The average score of the 26 internet sites was only $37.4{\pm}20.1$ out of a total of 100. A mean score of the contents was $13.3{\pm}8.3$ out of 40 points, the authorship was $10.0{\pm}6.7$ out of 20 points, the design was $9.2{\pm}5.3$ out of 20 points, the efficiency was $6.8{\pm}4.3$ out of 20 points. When comparing the score between anesthesiologist and non-anesthesiologist, the contents was $18.7{\pm}7.4$ vs. $11.7{\pm}7.9$, the authorship was $13.4{\pm}4.7$ vs. $9.0{\pm}6.8$, the design was $12.5{\pm}4.2$ vs. $8.3{\pm}5.2$ and the efficiency was $6.8{\pm}4.5$ vs. $4.3{\pm}4.0$ (P < 0.05). Conclusions: There is a need for more accurate information about postherpetic neuralgia on the Korean internet by anesthesiologists.

상흉부 이상 부위의 대상포진 및 대상포진후 신경통 환자에 대한 임상적 고찰 (Clinical Investigation of Herpes Zoster and Postherpetic Neuralgia above T4 Dermatome)

  • 정소영;신성의;윤덕미;오흥근;문봉기
    • The Korean Journal of Pain
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    • 제7권2호
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    • pp.242-248
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    • 1994
  • Postherpetic neuralgia is frequently painful, incapacitating, mood depressing, and sometimes lifelong. We investigated the influence of duration from eruption to nerve blocks in conjunction with patients age on analgesic and preventive effect for postherpetic neuralgia. We retrospectively evaluated 50 outpatient medical records for the above T4 dermatome. Patients had been referred to pain clinic and were treated over 2weeks from Jan. 1988 to Dec. 1993. Fifty patients were divided into 4 groups as follows: Group I (a): less than 4weeks from eruption to nerve block and younger than 65 years old. Group I (b): less than 4weeks from eruption to nerve block and older than 65 years old. Group II (a): more than 4weeks from eruption to nerve block and younger than 65 years old. Group II(b): more than 4weeks from eruption to nerve block and older than 65 years old. Mean number of stellate ganglion blocks were 29.7. Tramadol, amitriptyline, nicardipine were most commonly prescribed. Group I (a): had the most improvement rate(77.8%) as compared with other group(46.6, 52.7, 56.0%). Number of patients who complained of severe pain (VAS > 5) were 0, 3(39%), 2(15.4%), 5(30%) in I (a), I (b), II (a), II (b) group respectively. In conclusion, analgesic effect was best in cases of patients younger than 65 years old whose treatment were started within 4 weeks of eruption. Patients older than 65 yrs, analgesic effect did not vary on the timing of treatment.

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성상신경절 페놀차단 -증례 보고- (Stellate Ganglion Phenol Block -Case reports-)

  • 김대영;조희원;오홍근
    • The Korean Journal of Pain
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    • 제8권2호
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    • pp.312-318
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    • 1995
  • Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

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Ultrasound-Assisted Mental Nerve Block and Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: Three Case Studies

  • Park, Hae Gyun;Park, Pyung Gul;Kim, Won Joong;Park, Yong Hee;Kang, Hyun;Baek, Chong Wha;Jung, Yong Hun;Woo, Young Cheol;Koo, Gill Hoi;Shin, Hwa Yong
    • The Korean Journal of Pain
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    • 제27권1호
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    • pp.81-85
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    • 2014
  • Postherpetic neuralgia (PHN) is one of the most difficult pain syndromes to treat. Invasive treatments may be considered when patients fail to obtain adequate pain relief from noninvasive treatment approaches. Here, we present three cases of PHN in the mandibular branch treated with ultrasound-assisted mental nerve block and pulsed radiofrequency treatment. None of the patients had adequate pain relief from the medical therapy, so we performed the mental nerve block on the affected side under ultrasound assistance. Two patients showed satisfactory pain relief continuously over 12 months without any further interventions, whereas one patient only had short-term pain relief. For the patient had short-term pain relief we performed pulsed radiofrequency treatment (PRFT) on the left mental nerve under ultrasound assistance. After PRFT, the patient had adequate pain relief for 6 months and there was no need for further management.

상 경부 대상포진에 병발한 안면신경 마비 -증례 보고- (Facial Palsy Accompanied with Herpes Zoster on the Cervical Dermatome -A case report-)

  • 윤덕미;김창호;이윤우;남용택
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.97-100
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    • 1997
  • We treated a 56 year old male ailing of painful herpetic eruption on his 2nd, 3rd and 4th left cervical spinal segment. On the 18th day, patient also suffered an abrupt left facial palsy, accompanied with ongoing postherpetic neuralgia even though the skin eruption had been cured. This patient visited our pain clinic on his 46th day of illness and was teated with continuous cervical epidural block for 9 days, and stellate ganglion block plus oral analgesics and antidepressant for 12 days. The combination of treatments resulted in marked improvement of facial palsy and postherpetic neuralgia. A possible explanation of facial palsy accompanied with herpes zoster on cervical spinal segment could be related to Hunt's hypothesis that geniculate ganglion forms a chain connecting the high cervical ganglion below. Another possibility may be related to a compression injury of the facial nerve by long-term severe edema on the soft tissue of the face, the periauricular area and parotid gland around the facial nerve, and edema on the facial nerve itself emerging out from the cranium.

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