Acupuncture treatment of facial postherpetic itch

Abstract

This report describes a case of moderate postherpetic dysaesthesia (specifically itch), partial success, and alteration in symptom behaviour from a treatment approach using acupuncture and briefly reviews plausible mechanisms behind the pathology and treatment effect. Case report: A 70-year-old woman developed facial dysaesthesia in January 2006, which rapidly spread over the left maxillary and ophthalmic distribution. She was diagnosed with postherpetic neuralgia and started on a course of acyclovir. Months after the initial attack of herpes zoster, a left sided dysaesthesia persisted and the patient underwent treatment with carbamazepine, which was poorly tolerated and discontinued. Acupuncture treatment commenced at 30 months post-onset, using a combination of Eastern and Western hypothetico-deductive reasoning and point selection. After 5 months of intermittent treatment, specifically 20 treatments, the outcome was a 50% decrease in symptom severity as selfreported by the patient using a numeric rating scale. Conclusions: Acupuncture has been shown in some studies, to alter some anatomical and physiological parameters of the hypothetical mechanisms of neuropathic itch. This case suggests that acupuncture treatment, years after the initiating event, in this case herpes zoster, can bring about clinically significant improvement with respect to perceived intensity and severity of neuropathic itch.