• The Korean Journal of Pain
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• v.24 no.1
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• pp.53-56
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• 2011

Although postherpetic neuralgia (PHN) is a common chronic pain syndrome, the pathophysiology of this disorder is not well known and management is often very difficult. N-methyl-D-Aspartate (NMDA) receptor antagonists are known to be effective in PHN, and magnesium, a physiological blocker of NMDA receptors, is widely used to treat various chronic pain disorders. Here, we present a case of the PHN refractory to conventional treatment, which was treated successfully with transforaminal epidural injection of magnesium sulphate at the affected dermatome.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.188-190
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• 1999

Background: The goal of this study was to evaluate the effects of gabapentin on postherpetic neuralgia. Gabapentin is a known anti-seizure medication, whose cellular mechanism of action is not well understood. Unlike other anticonvulsant, gabapentin has the advantage of a low toxicity and favorable side effect profile. If has been recently recommended for use in treatment of neuropathic pain. Methods: Twelve patients with a diagnosis of postherpetic neuralgia were prescribed gabapentin after failure of routine therapeutic regimens. The dose of gabapentin ranged 300~1800 mg per day, in three divided doses. If initial dose was ineffective and no side effects were noted, the dosages was increased by 300 mg a day in divided doses, to the maximum level for 2 weeks. Patients were evaluated for analgesia using visual analogue scale (VAS) pain score (0; no pain, 10; worst possible pain) and possible side effects. Results: A significant decrease in pain scores with gabapentin were noted. There were several mild side effects such as dizziness, somnolence, dry mouth, constipation and facial edema, without need of special treatment. Conclusions: Gabapentin may be a useful adjunct for treating intractable postherpetic neuralgia with a minimal side effects.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.40-43
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• 1990

Herpes zoster is a common, usually self-limited disease distinguished by pain and a characteristic vesicular rash. The clinical onset of herpes zoster is heralded by pain in the area of the affected segment. So herpetic neuralgia is a major complaint from patients visiting the pain clinic. There are several methods for the treatment of herpetic neuralgia, but there is no method that results in complete remission. In 1988, King introduced the chloroform-aspirin topical application method. This method is known to be a very simple and effective treatment of acute herpetic neuralgia and postherpetic neuralgia. We used diethyl ether instead of chloroform as the solvent and treated 12 patients; 7 patients with herpetic neuralgia and 5 patients with postherpetic neuralgia. The results were follows, 1) The treatment has proved to be highly effective in relieving pain in acute herpetic neuralgia. 2) The application was very simple and safe to use and treatment tolerance has been excellent. 3) There were no effective results in postherpetic neuralgia. 4) The topical treatment seemed to promote the healing of the herpetic skin lesion.

• The Korean Journal of Pain
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• v.24 no.3
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• pp.169-171
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• 2011

Postherpetic neuralgia is the most frequent complication of herpes zoster. Treatment of this neuropathic pain syndrome is difficult and often disappointing. Although postherpetic neuralgia is generally a self-limited condition, it can last indefinitely. Continuous epidural blockade for patients with acute zoster can shorten the duration of treatment. However, continuous epidural block has some complications such as infection, dural puncture, and total spinal and nerve damages. We report a case of myoclonus during continuous epidural block with ropivacaine, morphine, and ketamine in an acute zoster patient.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.244-247
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• 1996

A 67 year old male with postherpetic neuralgia complained of right anterior chest throbbing pain and also allodynia. We performed thoracic epidural block with 0.25% bupivacaine and 1% lidocaine. Oral carbamazepine and imipramine were also administred concomitantly. One month later, patient complained of fatigue, anorexia, pruritis, jaundice, and dark urine. Liver function test values were significantly elevated then. Therefore we removed the epidural catheter and ceased all medication. Liver function test values decreased rapidly after discontinuation of medication. Hepatitis might have developed as result of drugs administered and could have been prevented if the patient had been monitored with regular clinical laboratory follow up. The purpose of this case report is emphasize the importance of early regular laboratory test to detect any possible side effect that may occur by administration of drugs during treatment of chronic pain.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.3
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• pp.127-139
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• 2018

Objectives : The purpose of this study is to report the effect of Traditional Korean Medical treatment on Postherpetic Neuralgia. Methods : Five patients suffering from postherpetic neuralgia were treated with Warm Needling, Bee venom Acupuncture, Cupping Therapy, Sipjeondaebo-tang. To evaluate the results of this treatment, we used Visual Analogue Scale(VAS), Pain Rating Scale(PRS), Quality of Sleep(QSP). Results : After treatment, VAS, PRS, QSP and clinical symptoms of 5 patients were improved remarkably. Conclusions : According to the results, These findings suggest that Traditional Korean Medical treatment can be effective for the treatment of postherpetic neuralgia.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.246-249
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• 1999

Postherpetic neuralgia (PHN) is defined as the persistence of pain after recovery from herpes zoster (HZ), when the rash has healed, usually after about 4 weeks. PHN is the most feared complication of herpes zoster and remains one of the most common and intractable chronic pain disorders. Recent evidence has shed some light on the possible mechanism of pain, and on the prophylactic and treatment approaches to PHN, but there is no secure therapy. This report is a case of a 70-year-old male with PHN, affecting the 8th to 10th thoracic dermatomes. Patient complains of allodynia and hyperalgesia on the affected skins. After sympathectomy, antidepressant, anticonvulsant, and capsaicin ointment application, much pain relief was achieved, but allodynia remained at the subcostal area about $7\times3 cm^2$ in size. We decided to remove the painful area. Skin excision was done under local anesthesia. After skin excision, the pain was decreased and patient did not complain of pain for 10 months.

• The Korean Journal of Pain
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• v.28 no.3
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• pp.177-184
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• 2015

Herpes zoster (HZ) is a transient disease caused by the reactivation of latent varicella zoster virus (VZV) in spinal or cranial sensory ganglia. It is characterized by a painful rash in the affected dermatome. Postherpetic neuralgia (PHN) is the most troublesome side effect associated with HZ. However, PHN is often resistant to current analgesic treatments such as antidepressants, anticonvulsants, opioids, and topical agents including lidocaine patches and capsaicin cream and can persist for several years. The risk factors for reactivation of HZ include advanced age and compromised cell-mediated immunity (CMI). Early diagnosis and treatment with antiviral agents plus intervention treatments is believed to shorten the duration and severity of acute HZ and reduce the risk of PHN. Prophylactic vaccination against VZV can be the best option to prevent or reduce the incidence of HZ and PHN. This review focuses on the pathophysiology, clinical features, and management of HZ and PHN, as well as the efficacy of the HZ vaccine.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.2
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• pp.125-133
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• 2001

Herpes Zoster Oticus is a reactivation of latent varicella-zoster infection associated otalgia, facial nerve palsy, sensorineural hearing loss and vertigo. Facial nerve palsy is rapid in onset, usually severe degree, and poor is prognosis. And pain in the form of acute neuritis and postherpetic neuralgia is by far the most frequent and most debilitating complication of Herpes Zoster. The pain of Herpes Zoster may severe, but it is usually transitory. Some patients, with the elderly at particular risk, go on to develop postherpetic neuralgia. In the two cases, pain (especially postherpetic neuralgia) which is often severe and, unfortunately, refractory to most forms of treatment was reduced using herbal medicine and acupuncture but facial nerve palsy was not improved.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.233-236
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• 2008

There are many causes of chronic abdominal pain and abdominal protrusion. But, they are likely to be confused with diabetic thoracic polyradiculopathy. Differentiation between this self-limiting complication and abdominal herniation is important to avoid unnecessary procedure. We describe the case of 77-years-old man with 10 years history of non-insulin dependent diabetes mellitus, who was suffering from postherpetic neuralgia for 10 months and presented with a abdominal segmental paresis and protrusion. The paraspinal electromyography showed bilateral lower thoracic radiculopathy.