• The Korean Journal of Pain
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• 제26권1호
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• pp.72-75
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• 2013

Zoster sine herpete (ZSH) is difficult to diagnosis during an acute period due to the absence of the characteristic zosteriform dermatomal rash; therefore, progression to postherpetic neuralgia is more common than typical zoster. In addition, misdiagnosis of other neuropathic pain as ZSH is common in clinical situations. Here, we report a case of spinal arteriovenous malformation that mimics ZSH. This is a rare condition; therefore, high clinical suspicion for a correct diagnosis and proper examination are not easy. However, early diagnosis and definitive treatment are essential to prevent neurologic deficit and mortality.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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• pp.333-337
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• 2018

Ramsay Hunt syndrome is a type of acute herpes zoster, which occurs by reactivation of the varicella-zoster virus at the geniculate ganglion. Clinical presentation of Ramsay Hunt syndrome includes a vesicular rash on the ear (herpes zoster oticus) or in the oral mucosa accompanied by acute peripheral facial nerve paralysis. Other cranial nerves such as V, IX, XI, and XII are often involved. Additional variability of the clinical picture of Ramsay Hunt syndrome is produced by varying patterns of skin involvement explained by individual anastomoses between cranial and cervical nerves. Combination treatment containing anti-viral agents and steroids is recommended for the treatment of Ramsay Hunt syndrome. Additionally, early diagnosis of Ramsay Hunt syndrome is a crucial factor to improve damaged nerves in Ramsay Hunt syndrome, which initiates treatment as soon as possible.

• Clinical and Experimental Vaccine Research
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• 제12권1호
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• pp.82-84
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• 2023

There were growing reports of herpes zoster reactivation after the coronavirus disease 2019 (COVID-19) vaccination, including a more severe form, herpes zoster ophthalmicus (HZO). A 35-year-old male presented HZO in his left V1 dermatome 10 days after his COVID-19 vaccine booster with Moderna (messenger RNA-1273). He had no history of chronic disease, immunocompromised, autoimmune, malignancy, or long-term immunosuppressive drug use. The rash improved without any further complications after being treated with oral valacyclovir for 7 days. This was a unique case of HZO after the COVID-19 vaccine in a booster setting in healthy younger adults. The association of herpes zoster after a COVID vaccine remained inconclusive and potentially coincidental, especially without the known risk factor. However, we would like to add a report to increase awareness among physicians and the general population, for early recognition and treatment with an antiviral.

• The Korean Journal of Pain
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• 제12권2호
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• pp.183-187
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• 1999

Background: The efficacy of nerve block on the progression of herpes zoster still remains controversy. The purpose of this study was to evaluate the efficacy of epidural blockade on the pain course of acute herpes zoster. Methods: Among 75 patients admitted with acute herpes zoster, 40 patients were treated with acyclovir and epidural block (epidural group), 35 patients were treated with acyclovir only (no block group). Follow up with patients was done for up to 3 months, either at the outpatient department or by telephone. The days required for pain relief were compared. We also investigated the factors associated with outcome. Results: Though statistically insignificant, patients in the epidural group tended to have faster pain relief. Patients with shorter symptom duration experienced significantly faster pain relief. But other factors such as sex, age, involved dermatome and other coexisting diseases (cancer, diabetes mellitus) were not associated with the outcome in this study. Conclusions: Though patients with epidural block leaded to have taster pair relief, more studies with larger patient population may be needed to confirm the efficacy of epidural block on herpes zoster.

• 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.

• 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.

• The Korean Journal of Pain
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• 제22권2호
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• pp.181-185
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• 2009

Herpes zoster is a viral disease of the posterior root ganglion and sensory nerve fiber, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, involvement of the motor neurons can be seen as well. If classic cutaneous lesions are present, herpes zoster-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be more difficult and suspicious, especially if weakness occurs as a symptom before cutaneous lesions appear, or abnormal findings on the MRI are consistent with the signs. There have been few reports of sciatica with motor loss preceding skin lesions. Here, we report a patient with herpes zoster-related motor paresis preceding skin lesions. In the preliminary diagnosis, the herpes zoster-related motor paresis was confused for some structural disorder.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• Tuberculosis and Respiratory Diseases
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• 제61권1호
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• pp.80-82
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• 2006

저자들은 경부 대상포진 후 횡격막 마비 1예를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1368-1371
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• 2008

영아에서의 대상포진은 매우 드문 질환이지만, 자궁 내에서 혹은 출생 후 수두 바이러스에 노출되어 발생할 수 있다. 태생기에는 바이러스에 대한 특이 면역글로불린 수치가 낮으며, 영아기에는 항원에 반응하는 림프구, 자연살해세포, 사이토카인이 적어 바이러스의 잠복기를 유지하기가 어려워, 이 때에 감염되는 경우 생후 1년 이내에 대상포진이 발병하는 것으로 알려져 있다. 저자들은 수두에 이환 되었거나 수두 예방접종을 받았던 적이 없었던 생후 4개월 영아에서 대상포진을 경험하였기에 보고하는 바이다. 환아의 어머니 역시 임신 중 수두에 감염되었거나 노출된 병력이 없었으며 환아는 대상포진에 병발된 포도상구균 감염에 대하여 acyclovir와 1세대 세팔로스포린으로 치료를 받고, 합병증 없이 치료되었다.