In accordance with our findings and recommendations provided by other authors, cladribine can be considered an effective alternative treatment for ECD, especially with CNS involvement and BRAF V600E-mutation-negative status, when interferon-alpha as the first-line therapy fails.
Coservative treatment consists of rest, physical therapy, pharmacological therapy and injection therapy. Physical rehabilitation with active patient participation is a key approach to treatment of patients with discogenic pain. Physical therapy, occupational therapy and kinesitherapy are important for improving muscle strength, endurance, and flexibility. Disc surgery is performed if surgical intervention is required.
Postherpetic intercostal neuralgia proved to be an incapacitating pain often recalcitrant to therapy. Acute pain that accompanied Herpes zoster usually subsides spontaneously but in 10% of patients the pain persists and intensifies. The incidence of postherpetic neuralgia incrises up to 50% among elder patients. We report the case of the two 42 and 48 yers old male patient who were succesfuly relieved from the chronic postherpetic intercostal neuralgia employing the DREZ surgery (Dorzal Root Entry Zone lesion). DREZ surgicall treatment of this pain should be considered when medical therapies failed in controling pain. Subjective sensory nature of the pain should play an important role in setting the indication for DREZ surgical treatment. The most favourable pain pattern for DREZ operation is the pain of intermittent rhythm, confined theritory accompanied with the phenomenon of alodinic pain that could be provoked from the pain theritory.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.