Cases reported "Herpes Zoster"

Filter by keywords:



Filtering documents. Please wait...

1/71. Treatment of postherpetic neuralgia.

    OBJECTIVE: To review treatment options for postherpetic neuralgia (PHN). DATA SOURCES: Clinical literature selected by the authors accessed via medline. Search terms included postherpetic neuralgia, capsaicin, antidepressants, anticonvulsants, and lidocaine. STUDY SELECTION: Controlled trials relevant to PHN. DATA SYNTHESIS: Traditional analgesics offer little benefit for the treatment of PHN. The best results for pain relief have come from capsaicin and tricyclic antidepressants. anticonvulsants have also been used, although the number of studies evaluating this is limited. More invasive therapies, such as transcutaneous electrical nerve stimulation and nerve blocks, can be considered if other therapies fail. CONCLUSION: early diagnosis and treatment of herpes zoster may offer patients the best chance of preventing the development of PHN. However, if PHN does develop, the patient should seek treatment early for the best chance of pain relief.
- - - - - - - - - -
ranking = 1
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

2/71. Acute herpetic neuralgia and postherpetic neuralgia in the head and neck: response to gabapentin in five cases.

    BACKGROUND AND OBJECTIVES: The clinical presentations and pharmacologic management of three patients with acute herpetic neuralgia (AHN) and two patients with postherpetic neuralgia (PHN), confined to the head and neck region, are described. methods: Two patients had pain in the ophthalmic division of the trigeminal nerve, two had pain confined to the C2-C4 dermatomes, and one patient had C2 pain with radiating and referred pain to the second and third divisions of the trigeminal nerve. RESULTS: Gabapentin, an anticonvulsant drug, was effective in treating these patients, including the two cases of AHN. All patients reported complete pain relief after titration with gabapentin up to 1,800 mg/d. The patients noted a dose-dependent decrease in pain almost immediately after starting gabapentin. Specifically, reduction in the frequency and intensity of allodynia, burning pain, shooting pain, and throbbing pain were noted. None of the patients experienced side effects from the drug. CONCLUSIONS: In view of the results in these patients, blinded, controlled studies are needed to determine the efficacy of gabapentin for treating AHN and PHN.
- - - - - - - - - -
ranking = 0.84638305968493
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

3/71. Patient-controlled epidural analgesia for postherpetic neuralgia in an hiv-infected patient as a therapeutic ambulatory modality.

    A 43-year-old hiv-positive male was referred to our pain clinic one month after his fourth attack of herpes zoster infection. He complained of intermittent intolerable sharp and lancinating pain accompanied by numbness over the inner aspect of the left upper extremity, left anterior chest wall and the back. physical examination revealed allodynia over the left T1 and T2 dermatomes without any obvious skin lesion. The pain was treated with epidural block made possible by a retention epidural catheter placed via the T2-3 interspace. After the administration of 8 ml of 1% lidocaine in divided doses, the pain was completely relieved for 4 h without significant change of blood pressure or heart rate. A pump (Baxter API) for patient-controlled analgesia (PCA) filled with 0.08% bupivacaine was connected to the epidural catheter on the next day and programmed at a basal rate of 2 ml/h, PCA dose 2 ml, lockout interval 15 min, with an one-hour dose limit of 8 ml. He was instructed to report his condition by telephone every weekday. The pump was refilled with drug and the wound of catheter entry was checked and managed every 3 or 4 days. The epidural catheter was replaced every week. During treatment, the pain intensity was controlled in the range from 10 to 0-2 on the visual analogue scale. He was very satisfied with the treatment and reported only slight hypoesthesia over the left upper extremity in the early treatment period. Epidural PCA was discontinued after 28 days. He did not complain of pain thereafter but reported a slight numb sensation still over the lesion site for a period of time. In conclusion, postherpetic neuralgia in an hiv-infected man was successfully treated with ambulatory therapeutic modality of epidural PCA for 28 days.
- - - - - - - - - -
ranking = 0.83333333333333
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

4/71. Acute varicella zoster with postherpetic hyperhidrosis as the initial presentation of hiv infection.

    A 31-year-old man presented with acute pain in his left arm and hemorrhagic vesicles that followed his left 8th cervical nerve. A diagnosis of herpes zoster was made, and the patient was treated with valacyclovir. He refused testing for antibodies to hiv because he denied being at risk. Two months later he returned with postherpetic neuralgia and postherpetic hyperhidrosis in the distribution of the vesicles, which had since resolved. serology for hiv at this visit was positive, and the patient admitted to having sexual relations with prostitutes. Six months later the patient was being treated with triple antiretroviral therapy, and all signs and symptoms of postherpetic zoster had resolved. This case report documents the need for hiv testing in patients with unusual presentations of herpes zoster even if they initially deny being at risk.
- - - - - - - - - -
ranking = 1.1510069950447
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

5/71. herpes zoster in the elderly: issues related to geriatrics.

    This article reviews specific clinical and research issues of herpes zoster related to geriatric medicine. Salient epidemiological and clinical issues include the increasing probability of zoster and postherpetic neuralgia with aging, age-related decline in immunity to varicella-zoster virus, the functional and psychosocial impact of zoster on the quality of life of the elderly, illness behavior in elderly patients with zoster, and varicella-zoster virus transmission and control in the nursing home. The role of antiviral therapy, corticosteroids, and analgesics; the measurement and analysis of pain, health-related quality of life, and functional status; and development of the varicella vaccine in the management of zoster in the elderly are also emphasized. Fertile research opportunities exist within these areas for investigators interested in infectious diseases, geriatrics, and other zoster-related disciplines.
- - - - - - - - - -
ranking = 0.16666666666667
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

6/71. A study of post-traumatic shingles as a work related injury.

    BACKGROUND: After chicken pox, the herpes varicella-zoster (HVZ) virus may remain dormant in the dorsal root ganglion until later reactivation causes shingles, characterized by painful dysesthesias and cutaneous vesicular eruptions along a unilateral dermatome. Shingles as a work-related injury has not been previously addressed in the medical literature. Case history We present a 50-year old female hospital employee who, while working, sustained an acute, traumatic hyperextension injury to her right wrist, hand, and fingers. Although she initially responded to treatment for flexor tendinitis, she suddenly developed shingles in the right C5-C6 dermatomes. She was treated with famcyclovir and her skin lesions resolved, but post-herpetic neuralgia persisted. CONCLUSIONS: It was felt that her shingles was causally related to her occupational injury since trauma (previously reported to precipitate shingles) was her only risk factor and the timing and location of the lesions corresponded closely to the occupational injury. In addition to appropriately diagnosing and treating their patients, workers' compensation physicians often must determine if a particular condition was caused by the original work-related incident. Clinicians who treat trauma patients and injured workers should be aware of post-traumatic shingles and understand the causal relationship of this uncommon but clinically important phenomenon.
- - - - - - - - - -
ranking = 0.0026099452703198
keywords = neuralgia
(Clic here for more details about this article)

7/71. Recurrent disseminated herpes zoster and cytomegalic perianal ulcer: a case report and review of the literature.

    We describe a patient with lymphocytic leukemia who developed multiple, disseminated, vesiculopustular eruptions in combination with perianal ulcer. Four years earlier, she had a herpes zoster (HZ) infection involving the ophthalmic division of her left trigeminal nerve with subsequent postherpetic neuralgia that was treated with steroids. After the studies, we concluded that the patient had a recurrent disseminated HZ infection and perianal ulcer caused by cytomegalovirus (CMV).
- - - - - - - - - -
ranking = 0.16666666666667
keywords = postherpetic, neuralgia
(Clic here for more details about this article)

8/71. Varicella zoster meningitis preceeded by thrombophlebitis in a patient with Hodgkin's disease.

    Varicella zoster (V-Z) infections are common among patients with hematological malignancies, particularly Hodgkin's disease (HD). The common denominator in both HD and V-Z infections is immunosuppression. Most of V-Z infections occur in patients with HD during the remission period, who have mixed cellularity sub-type, with stage III disease and who have received combined chemo-radiation therapy. Involvement of the central nervous system usually manifests as post-herpetic neuralgia or encephalitis. Angiitis has also been found in association with V-Z infections. The authors describe a case of HD who developed V-Z meningitis preceeded by superficial thrombophlebitis of upper extremities during the period of active chemotherapy.
- - - - - - - - - -
ranking = 0.0026099452703198
keywords = neuralgia
(Clic here for more details about this article)

9/71. Opioids in non-cancer pain: a life-time sentence?

    There is continuing reluctance to prescribe strong opioids for the management of chronic non-cancer pain due to concerns about side-effects, physical tolerance, withdrawal and addiction. Randomized controlled trials have now provided evidence for the efficacy of opioids against both nociceptive and neuropathic pain. However, there is considerable variability in response rates, possibly depending on the type of pain, the type of opioid and its route of administration, the time to follow-up, compliance and the development of tolerance. Five patients were selected with nociceptive or neuropathic pain in whom other pharmacological or physical therapies had failed to provide satisfactory pain relief. They received transdermal fentanyl (starting dose 25 microg/h) for at least 6 weeks. Transdermal fentanyl dosage was titrated upwards as required. Transdermal fentanyl provided adequate pain relief in patients with nociceptive pain (diabetic ulcer, osteoporotic vertebral fracture, ankylosing spondylitis) or neuropathic pain with a nociceptive component (radicular pain due to disc protrusion, herpetic neuralgia). The duration of treatment ranged from 6 weeks to 6 months for four cases. In the case of ankylosing spondylitis, treatment was carried out for 2 years, stopped and then restarted successfully. There were no withdrawal effects or addictive behaviour on treatment cessation, regardless of duration of the treatment. In conclusion, strong opioids may provide prolonged effective pain relief in selected patients with nociceptive and neuropathic non-cancer pain. Transdermal fentanyl treatment can often be temporary and can easily be stopped following adequate pain relief without withdrawal effects or any evidence of addictive behaviour.
- - - - - - - - - -
ranking = 0.0026099452703198
keywords = neuralgia
(Clic here for more details about this article)

10/71. Documented arterial gas embolism after spinal epidural injection.

    We report the case of a 90-year-old man with syncope, arrhythmia, cardiac ischemia, and neurologic deficit after undergoing spinal epidural injection for control of pain related to post-herpetic neuralgia. The diagnosis of arterial gas embolus was made after air was identified in the left ventricle of the heart on an abdominal computed tomographic scan. Emergency physicians should consider and rapidly diagnose this rare but potentially fatal complication of spinal epidural puncture.
- - - - - - - - - -
ranking = 0.0026099452703198
keywords = neuralgia
(Clic here for more details about this article)
| Next ->


Leave a message about 'Herpes Zoster'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.