Current review of pain
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Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, and as such has been an area of extensive medical research for the past three decades. The patients at highest risk for PHN include those older than 50 years, those with severe acute cases of zoster, and those with shingles in a trigeminal distribution. As persons with malignancy are at a high risk for developing zoster itself, PHN is a complication that will be faced by many of these patients and their caregivers. This article reviews the available treatments and preventative measures for this debilitating condition.
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Postherpetic neuralgia (PHN) is the most common and devastating complication of acute herpes zoster (HZ). HZ occurs more frequently in the patient with human immunodeficiency virus (HIV) and with certain leukemias and lymphomas. PHN occurs more frequently in the elderly, in patients with severe pain in the acute stage, and in patients with lesions in the ophthalmic branch of the trigeminal nerve. ⋯ A wide variety of therapeutic approaches have been advocated over the years, but most are not very effective. Early aggressive treatment of HZ with antiviral drugs may be the most important step in prophylaxis against PHN. This article reviews the current knowledge of the pathogenesis and treatment of PHN.
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Current review of pain · Jan 2000
ReviewThe role of radiofrequency in the management of complex regional pain syndrome.
The nomenclature, pathophysiology, and treatment modalities of complex regional pain syndrome (CRPS) are controversial. Thus far there are no specific, scientifically valid treatments for the management of CRPS. ⋯ Minimally invasive radiofrequency lesioning for managing CRPS is a modality in its developmental stages. This article describes radiofrequency lesioning techniques in managing CRPS.
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Uncommon stimulation refers to the use of peripheral nerve and spinal cord stimulation for nontraditional applications. There has been much interest recently with subcutaneous suboccipital stimulation for occipital neuralgia, sacral stimulation for pelvic pain, trigeminal stimulation for trigeminal neuralgia, and spinal cord stimulation for angina and peripheral ischemia. The indications and techniques used for accomplishing each method are discussed.