• The Korean Journal of Pain
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• v.26 no.1
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• pp.98-101
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• 2013

Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster, especially in elderly and comorbid patients. Unfortunately, the currently available treatments have shown limited efficacy and some adverse events that are poorly tolerated in elderly patients. Scrambler Therapy, proposed as an alternative treatment for chronic neuropathic pain recently, is a noninvasive approach to relieve pain by changing pain perception at the brain level. Here, we report our clinical experiences on the effect of Scrambler Therapy for three patients with PHN refractory to conventional treatment.

• 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.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.7 no.2
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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.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.136-141
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• 1991

Fifteen patients was analyzed on effect of the management of postherpetic neuralgia by local anesthesia on the special region at pain clinic in Youngnam University Hospital. The results were on follows : 1) The frequency of occurrence of sex and the lesion side were similar in all patients. 2) The age of incidence was between 50 and 70 years old. 3) The most frequent site of lesions was the neck. 4) There was no relationship between age and treatment time. 5) Whole patients was done average 7-10 time local injection.

• 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.

• 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.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.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.235-243
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• 2018

Postherpetic neuralgia (PHN) is the most troublesome side effect of Herpes Zoster (HZ), which mainly affects the elderly and immunocompromised populations. Despite the current advancement of treatments, PHN persists in many individuals influencing their daily activities and reducing their quality of life. Anticonvulsants, antidepressants, topical therapies including lidocaine and capsaicin, and opioids, are the most widely used therapies for the treatment of PHN. These medications come with their adverse effects, so they should be used carefully with the elderly or with patients with significant comorbidities. Other measures like botulinum toxin, nerve blocks, spinal cord stimulation, and radiofrequency have also contributed significantly to the management of PHN. However, the efficacy, safety, and tolerability of these invasive methods need to be carefully monitored when administering them. Early diagnosis and early initiation of treatment can reduce the burden associated with PHN. The zoster vaccine has effectively reduced the incidence of HZ and PHN. In this article, we discuss the treatment options available for the management of PHN, mainly focusing on the efficacy and safety of different therapeutic modalities.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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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.