• Journal of Medicine and Life Science
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• v.16 no.1
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• pp.1-5
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• 2019

Our purpose was to evaluate usefulness of the contrast-enhanced 3 dimensional fluid attenuated inversion recovery (3D-FLAIR) technique of half brain volume to diagnose the patients with facial neuritis based on segment-based analysis. We assessed retrospectively 17 consecutive patients who underwent brain MR imaging at 3 tesla for facial neuritis: 11 patients with idiopathic facial neuritis and 6 with herpes zoster oticus. Contrast enhanced 3D-FLAIR sequences of the half brain volume were analyzed and 3D T1-weighted sequence of the full brain volume were used as the base-line exam. Enhancement of the facial nerve was determined in each segment of 5 facial nerve segments by two radiologists. Sensitivity, specificity and accuracy of enhancement of each segment were assessed. The authors experienced a prompt fuzzy CSF enhancement in the fundus of the internal auditory canal in patients with enhancement of the canalicular segment. Interobserver agreement of CE 3D-FLAIR was excellent(${\kappa}$-value 0.885). Sensitivity, specificity, and accuracy of each segment are 1.0, 0.823, 0.912 in the canalicular segment; 0.118, 1.0, 0.559 in the labyrinthine segment; 0.823, 0.294, 0.559 in the anterior genu; 0.823, 0.529, 0.676 in the tympanic segment; 0.823, 0.235, 0.529 in the mastoid segment, respectively. In addition, those of prompt fuzzy enhancement were 0.647, 1.0, and 0.824, respectively. Incidence of prompt fuzzy enhancement with enhancement of the canalicular segment was 11 sites(55%): 6 (54.5%) in idiopathic facial neuritis and 5 (83.3%) in herpes zoster. Enhancement of the canalicular segment and prompt fuzzy enhancement on CE 3D-FLAIR was significantly correlated with occurrence of facial neuritis (p<0.001). CE 3D-FLAIR technique of the half brain volume is useful to evaluate the patients with facial neuritis as an adjunct sequence in addition to contrast-enhanced 3D T1-weighted sequence. On segment-based analysis, contrast enhancement of the canalicular segment is the most reliable. Prompt fuzzy enhancement is seen in not only herpes zoster, but in idiopathic facial neuritis.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.299-302
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• 2006

Segmental zoster paresis is characterized by focal, asymmetric motor weakness in the myotome corresponding to the dermatome of the rash. A 73-year-old man, who presented with severe right shoulder pain and shoulder girdle muscle weakness, was diagnosed with segmental zoster paresis involvement of the C5⁣-C6 motor roots as a complication of herpes zoster. Girdle muscles (supraspinatus, deltoid and infraspinatus) atrophy had developed in his right shoulder. An MRI showed rotator cuff tearing in his right shoulder; therefore, an arthroscopic rotator cuff repair was performed. Herein, this case is presented to emphasize the importance of considering post-herpetic segmental motor paresis in the differential diagnosis of acute painful motor weakness of the upper extremities.

• Journal of the Korea Convergence Society
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• v.12 no.8
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• pp.327-333
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• 2021

Zoster-associated pain (ZAP) in patients with herpes zoster (HZ) may persist for a long time, occurring even years after the rash has healed. In this case, the patient is diagnosed as having postherpetic neuralgia (PHN). Prodromal symptoms can present with constant or intermittent pain, and are often accompanied by other symptoms, resulting in misdiagnosis and/or inappropriate treatment. The aim of this study is to investigate the characteristics of the prodromal symptoms of ZAP through a multicenter study in Korea.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.147-150
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• 2012

Purpose: Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature. Methods: A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology. Results: We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months. Conclusion: Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.110-117
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• 2022

Herpes zoster (HZ) has been reported in immunocompetent children who received the varicella vaccine. In vaccinated children, HZ can be caused by vaccine-strain or by wild-type varicella-zoster virus (VZV). Like wild-type VZV, varicella vaccine virus can establish latency and reactivate as HZ. We report two cases of HZ in otherwise healthy 16- and 14-month-old boys who received varicella vaccine at 12 months of age. They presented with a vesicular rash on their upper extremities three to four months after varicella vaccination. In one case, a swab was obtained by abrading skin vesicles and VZV was detected in skin specimens by polymerase chain reaction. The VZV open-reading frame 62 was sequenced and single nucleotide polymorphism analysis confirmed that the virus from skin specimen was vaccine-strain. This is the first HZ case following varicella vaccination confirmed to be caused by vaccine-strain VZV in the immunocompetent children in Korea. Pediatricians should be aware of the potential for varicella vaccine virus reactivation in vaccinated young children.

• The Korean Journal of Pain
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• v.10 no.1
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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.

• Journal of Haehwa Medicine
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• v.25 no.1
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• pp.53-62
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• 2016

Objectives : The purpose of this study was to report a case of a patient efficacy of electromagnetic acupuncture using Whata 153 in facial nerve palsy in Herpes zoster oticus. Methods : We treated the patient with magnetic acupuncture combined with electro-acupuncture. Acupuncture points were at the face (BL2, GB14, TE23, ST4, ST6, ST3). All the acupuncture points were stimulated with magnetic field and 4 of them were combined with electro-acupuncture. Results & Conclusions : The improvement of facial movement and symptom was evaluated by Yanagihara grading system(Y-system), House-Brackmann scale(HB scale) and Sunnybrook facial grading system(SFGS). After treatment, all of the scales(Y-system, HB scale and SFGS) and symptom of the patient were improved. From the above results, we suggest that magnetic acupuncture and electro-acupuncture might be effective on facial nerve palsy in Herpes zoster oticus.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.127-130
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• 1995

A 34 year old male patient visited to our neuro-pain clinic with symtoms of a left frontal headache, eyeball throbbing and occipital pain. Two days after the first visit to our clinic. pain was aggrevated and the skin eruption appeared on the left forehead. He was diagnosed as raving Herpes Zoster Opthalmicus(HZO). We performed stellate ganglion block(SGB), but pain did not subsid. So a continuous cervical epidural block was perfomed(CCEB) and it could relieve the pain promptly. In this case, VAS(visual analogue scale) was diminished from 10 to 3 and the skin eruption was healed 24 days after the treatment with CCEB and SGB. We experienced that CCEB is more effective rather than intermittent SGB in intractable HZO. CCEB should be considered to the treatment of choice in patients with HZO.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.3-8
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• 1988

Authors have experienced the treatment for the uppermost frequent cases, herpes zoster, frozen shoulder and low back pain among those who visited our pain clinic. 1. Herpes zoster The Patients who received the treatment within 4 weeks of the onset of the disease, not only healed herpes without leaving post herpetic neuralgia but also crust formation was fast. 2. Frozen shoulder Over 90% of the patients who received suprascapular nerve block accompanied with trigger points electric stimulation was very efficient procedure, futhermore, authors felt keenly the necessity each patients co-operation and individual endurance for this treatment. 3. Low back pain An epidural steroid administration to the patients who did not have any organic disturbances was effective treatment. If this non-effective, search other cause of the disease or operation was advisable one.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.349-356
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• 1997

an acute, unilateral, self-limited inflammatory disease of cerebral ganglia and the ganglia of posterior nerve roots and peripheral nerves in a segmented distribution, caused by the chickenpox virus, and characterized by groups of small vesicles in the cutaneous areas along the course of affected nerves, and associated with neuralgic pain. three case of herpes zoster has severe post herpetic neuralgia. these patients has been treated with westernmedicine. But they could not expect to improve condition. We exprienced three cases of herpes zoster that have a result of effect with oriental treatment and lazer threaphy.