S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia

Gross, Gerd; Eisert, Lisa; Doerr, Hans Wilhelm; Fickenscher, Helmut; Knuf, Markus; Maier, Philip; Maschke, Matthias; Müller, Rainer; Pleyer, Uwe; Schäfer, Michael; Sunderkötter, Cord; Werner, Ricardo Niklas; Wutzler, Peter; Nast, Alexander

doi:10.1111/ddg.14013

Cited by 68 publications

(123 citation statements)

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“…Following the latest S2k guidelines, lidocaine patches are recommended as second-line treatment for postherpetic neuralgia. 41 Some evidence has indicated that lidocaine could affect the release of pro-inflammatory and anti-inflammatory cytokines 42,43 and inhibit peripheral and central sensitization, 44 resulting in analgesic effects. 45 To make our interventions as comparable as possible, all patients received local injection therapies to increase adherence to treatment regimens.…”

Section: Discussionmentioning

confidence: 99%

“…Topical therapy with lidocaine is effective and well supported by evidence. Following the latest S2k guidelines, lidocaine patches are recommended as second‐line treatment for postherpetic neuralgia 41 . Some evidence has indicated that lidocaine could affect the release of pro‐inflammatory and anti‐inflammatory cytokines 42,43 and inhibit peripheral and central sensitization, 44 resulting in analgesic effects 45 .…”

Section: Discussionmentioning

confidence: 99%

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Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

et al. 2020

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Objectives: The ophthalmic branch of the trigeminal nerve is one of the most frequently involved sites of postherpetic neuralgia. A single-center randomized controlled study was conducted to evaluate the efficacy of local methylcobalamin injection for subacute ophthalmic herpetic neuralgia (SOHN). Methods: One hundred and five patients with a pain score of 4 or greater were randomized to receive a combination of methylcobalamin and lidocaine via local injection (LM group, n = 35), intramuscular methylcobalamin and local lidocaine injection (IM group, n = 35), and oral methylcobalamin tablet and lidocaine local injection (OM group, n = 35) for 4 weeks. Multilevel mixed modeling was employed to examine treatment responses. Results: Pain scores were reduced in all groups, but this reduction was significantly greater in the LM group (6.7 at baseline vs. 2.8 at endpoint) when compared with systemic administration (IM group 6.8 vs. 4.9, OM group 6.7 vs. 5.1). Clinically relevant reduction of pain (>30%) was seen in 91% of patients in the LM group, a significantly greater proportion than in the systemic groups (66% IM group, 57% OM group). Analgesic use reduced significantly in the LM group (94% at baseline vs. 6% at endpoint) but not in systemic groups (IM group 97% vs. 86%, OM group 94% vs. 80%). Health-related quality of life was higher in the LM group than in the systemic groups. In mixed modelling, increased age was associated with a lower response to methylcobalamin. Conclusions: This study indicates that local injection of methylcobalamin produces significant pain relief from SOHN and is superior to systemic administration. &

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

et al. 2020

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“…While most patients' symptoms settle down within a week with only simple analgesia, others might need antiviral medications like acyclovir, valacyclovir, famciclovir, and brivudine [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Shingles (Herpes Zoster) Mimicking Acute Abdomen

Monib

Pakdemirli

2020

Cureus

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Shingles is a very well-known viral infection caused by the varicella-zoster virus leading to painful skin rash. Although shingles can occur anywhere, it most often appears as a single stripe of blisters around the hypochondriac region. We are presenting a rare atypical presentation of shingles, as our patient presented with a picture of the acute abdomen a couple of days prior to the eruption of skin lesions.

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“…Although certain patients have a certain tendency to self-heal, PHN can develop in case the virus in the body is not cleared in time and the pain in the affected area lasts for more than 3 months. Its severity usually depends on the presence of pain before the formation of the rash, the severity of the rash, the sex, age, and impaired immune function [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a lack of effective treatment is present, which increases the social medical and family burden 11 . At present, the clinical treatment 12 of PHN is mainly divided into the two following categories: drugs 10,13,14 and surgery 15,16 . When the application of drugs is ineffective or the side effects caused are unbearable, surgery is considered 16 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study

Zhu

Xie

Liu

et al. 2020

Preprint

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Background: At present, different views have been proposed on the radiofrequency treatment modes and parameters of radiofrequency thermocoagulation of the spinal dorsal root ganglion for the treatment of postherpetic neuralgia. It is urgent to identify a novel and more effective radiofrequency therapy for patients with postherpetic neuralgia. Methods: A total of 60 patients who underwent radiofrequency thermocoagulation therapy for postherpetic neuralgia in the pain department of our Hospital were retrospectively reviewed from January 2013 to November 2017. According to the different surgical methods, the patients were divided into the following groups: unipolar group (CRF) and bipolar group (DCRF). Subsequently, the pain scores (NRS) were evaluated at the following specific time points: before the operation, on the 1st day after the operation, in 3 and 6 months after the operation and in 1 and 2 years after the operation. Moreover, the incidence of intraoperative and postoperative complications and the degree of pain relief were evaluated in order to assess the efficacy and prognosis of radiofrequency thermocoagulation in the two groups. The in vitro ovalbumin experiment was used to indicate the effects of unipolar and bipolar radiofrequency thermocoagulation.Results: In this study, the intra-group comparison indicated that compared with the preoperative NRS, the postoperative NRS decreased significantly; the inter-group comparison demonstrated that the NRS of the DCRF group was lower than that of the CRF group at all time points from 6 months to 2 years following the operation. The total effective rate of the DCRF group was significantly higher than that of the CRF group in 2 years following the operation. The incidence of numbness in the DCRF group was higher than that noted in the CRF group at each time point following the operation. The ovalbumin experiments in vitro indicated that the effects of radiofrequency thermocoagulation were optimal when the distance between the two needles was 5 mm.Conclusion: Bipolar spinal root ganglion radiofrequency thermocoagulation exhibits a longer duration and higher effective rate in the treatment of postherpetic neuralgia and it’s a treatment method worth promoting.

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S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia

Cited by 68 publications

References 0 publications

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

Shingles (Herpes Zoster) Mimicking Acute Abdomen

Evaluation of the Efficacy of Unipolar and Bipolar Spinal Dorsal Root Ganglion Radiofrequency Thermocoagulation in the Treatment of Postherpetic Neuralgia: a Retrospective Study

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