• The Korean Journal of Pain
• /
• v.33 no.3
• /
• pp.201-207
• /
• 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.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.36 no.2
• /
• pp.41-47
• /
• 2022

Postherpetic neuralgia(PHN) is one of the most common intractable chronic pain syndromes. This review was conducted to investigates the trends in recent clinical studies of PHN in China and to find out the efficacy of Chinese medicine treatment for PHN. Based on CNKI databases, nineteen randomized controlled trials(RCTs) were analyzed. The search focused on the authors, publication year, sample size, age, duration of illness, treatment period, lesion sites, methods, outcome measures, and results of the selected articles. Four studies used herbal medicine. The most frequently used herbs were Angelicae Gigantis Radix(當歸) and Corydalis Tube(玄胡索). Eighteen studies used acupuncture treatment. The most frequently used acupoints were ST36, LR3, LI4. Three studies used moxibustion and 5 studies used cupping treatment. In all nineteen studies, the efficacy of Chinese medicine treatments was confirmed. More varied and scientifically designed clinical studies are required to develop treatments for PHN. The results of current study could be used as guidance for further studies of treatment on PHN.

• The Korean Journal of Pain
• /
• v.5 no.2
• /
• pp.258-262
• /
• 1992

Herpes zoster is an acute infectious viral disease which affects the posterior spinal root ganglion of the spinal nerve. A single posterior spinal root ganglion or a small number of adjacent ones may be affected, usually on the same side. The corresponding ganglia of the cranial nerve may also be similarly affected. The causative virus, varicella zoster, belongs to the group of host-specific DNA viruses. Postherpetic neuralgia is a continuation of herpes zoster in older patients. Although spontaneous resolution of herpes zoster may be expected in most patients, a significant number experience intractable pain. Postherpetic neuralgia is one of the most difficult problems encountered by physicians. There are many methods for management of postherpetic neuralgia, but there is no method that results in complete remission. Laser has lately come into use to reduce several acute or chronic pains. In order to determine the degree of pain relief by laser, 27 patients of postherpetic neuralgia were irradiated with He Ne, Infrared, and $CO_2$ combine scan moded lasers two to three times per week. The results were as follows: 1) The most frequent site was thoracic vertebral nerve area. 2) Patients younger than 70 years of age showed an improvement rate of 57% vs 27% for those patients older than 70 years of age. 3) Laser therapy proved effective of those patients who received the laser treatment within one month of the onset of the disease. 4) For those patients who received treatment within one month of the disease and reflecting a 50% improvement rate, the average irradiation time was 5.7.

• The Korean Journal of Pain
• /
• v.22 no.2
• /
• pp.141-145
• /
• 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.

• The Korean Journal of Pain
• /
• v.27 no.1
• /
• pp.1-2
• /
• 2014

• The Korean Journal of Pain
• /
• v.28 no.3
• /
• pp.167-168
• /
• 2015

• Journal of Oral Medicine and Pain
• /
• v.35 no.1
• /
• pp.93-99
• /
• 2010

Herpes zoster (HZ) is the secondary manifestation of an earlier infection with the varicella-zoster virus in one or more dermatomes. As reactivation of the virus is linked to an age-related diminished virus-specific and cell-mediated immunity, HZ develops mainly in elderly people. Acute zoster is painful, but does not incur lasting morbidity. Reactivation of the varicella-zoster virus in the trigeminal nerve (Herpes zoster) occur with severe pain and rash in the oro-facial region. The acute pain decreases as the rash begins to heal. Postherpetic neuralgia(PHN), the most frequent complication of herpes zoster, is usually defined as pain in the involved dermatome that is still present 3 month after rash onset. The clinical characteristics of PHN are, eposodic stabbing pain, burning pain and allodynia, with hypoesthesia and/or dysesthesia. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.) is convenient, rapid and noninvasive, and allows objective assessment of sensory disturbance. This case is about the postherptic neuralgia patient assessed with $Neurometer^{(R)}$. From this case, we reviewed the pathophysiology and the treatment of PHN and recommend the assessment of pain intensity with $Neurometer^{(R)}$ as quantitative and objective method.

• The Korean Journal of Pain
• /
• v.3 no.2
• /
• pp.131-138
• /
• 1990

Postherpetic neuralgia (PHN) causes intractable pain which disturbs sleep and daily life. Numerous drugs and treatment strategies have been introduced for the management of PHN. However, no single regimen has proved to be effective. I analysed 38 patients with PHN. Amitriptyline, a tricyclic antidepressant and chlorpromazine were most commonly prescribed. Stellate ganglion blocks for the head and neck pain and epidural blocks for the rest part of the body were most frequently given. Triamcinolone acetate was administered epidurally in most of the cases or by iontophoresis on the affected skin area in two cases. Complications were related to the technique of the nerve block and the side effects of drugs administered. Repeated nerve blocks with tricyclic antidepressant and steroid therapy were thought to be the most effective for the treatment of postherpetic pain.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.127-130
• /
• 1997

A 67-year old man with a history of cardiac disease underwent epidural catheterization for pain control of postherpetic neuralgia. Patient had severe back pain and pus discharge at catheter insertion site after dischange from medical part. Patient received anticoagulant therapy with $Aspirin^{(R)}$ and $Coumadin^{(R)}$ prescribed for 15 days in medical part. Magnetic resonance imaging(MRI) showed a diffuse $T_{4-7}$ anterior epidural mass compressing the spinal cord. Emergency surgical exploration revealed a thoracic epidural hematoma without abcess formation. Operation was successful and patient recovered satisfactory without any sequelae.

• The Journal of Korean Medicine
• /
• v.20 no.4
• /
• pp.106-114
• /
• 2000

The herpes zoster infecting ophthalmic branch of trigeminal Nerve that is similar to migraine at first stage symptom has been treated with oriental medication at Dept. of Internal Medicine, Semyung University Oriental Hospital. The fIrst symptom of roster is burning pain, tingling or extreme sensitivity in one area of the skin, usually limited to one side of the body. This may be present for one to three days before a red rash appears at that site. There may also be a fever or headache. The rash soon turns into groups of blisters. The blisters start out clear but then pus or dark blood collects in the blisters before they crust over (scab) and begin to disappear. The pain may last longer. In this case, the severe pain was present for five days, the blisters and scabsdisappeared entirely on the seventeenth day, but postherpetic neuralgia, the most common complication and is observed most frequently in the ophthalmic branch of trigeminal nerve, was not prevented entirely. We have observed this case and report to help treatment on this disease at oriental medicine clinic.