Articles: neuralgia.
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Randomized Controlled Trial Clinical Trial
Effect of oral acyclovir on pain resolution in herpes zoster: a reanalysis.
The most frequent complication of herpes zoster is postherpetic neuralgia, usually defined as chronic pain in the area of the exanthem that persists for at least a month after the skin lesions have healed. Several clinical studies of acyclovir showed a reduction in severity and duration of acute pain, but provided no definitive data for chronic pain. In order to determine if acyclovir therapy could reduce chronic pain, we reanalyzed data from the largest U. ⋯ By considering pain as a continuum, we found that the median duration of pain in acyclovir recipients was 20 days vs. 62 days for their placebo counterparts (P = 0.02). Thus, acyclovir has been shown to reduce chronic zoster-associated pain. We also noted that the absence of pain at the onset of cutaneous herpes zoster did not preclude its later development.
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Acta neurochirurgica · Jan 1993
Ultrasonic DREZ-operations for treatment of pain due to brachial plexus avulsion.
One, if not the only effective way of treating pain due to preganglionic avulsion of the brachial plexus is the Dorsal Root Entry Zone (DREZ) lesion procedure. In 1985 the author began to use ultrasound as a lesion-maker for operations in the DREZ. Since then, 127 (3 patients were operated on twice) DREZ-Operations have been carried out on 124 patients suffering from chronic pain due to brachial plexus avulsion. ⋯ Analysis of the results after ultrasonic DREZ-operations revealed that ultrasonic DREZ-sulcomyelotomy was the most effective technical modality. Immediately after operation good pain relief was obtained in 103 (96%) out of the 107 patients operated on with the ultrasonic DREZ-sulcomyelotomy method, and in 15 (75%) out of the 20 patients with ultrasonic discontinuous DREZ-lesions. The total follow-up study (47.5 months on average) revealed 87% good results overall.
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After remission of the dermatological symptoms of herpes zoster infection, post-zoster neuralgia (PZN) can persist or recur for months and years. Most frequently, satisfactory therapy of PZN is not possible. During recent years the persistence of viruses on the surface of neuronal cells has been discussed as the possible reason for chronic pain. ⋯ Treating pain in persistent PZN is extremely difficult and mostly results in a small diminution of the pain level. Persistence of viruses on the neuronal cell surface and resulting reduction of "luxury functions" of those cells may explain algogenesis by PZN and resistance to therapeutic efforts. We used VZI for the first time for therapy of PZN and observed a striking analgesic effect in all patients for the entire surveillance time.