Chronic postherpetic neuralgia.

Abstract

• The course of postherpetic neuralgia was studied in 35 patients, some of whom had suffered severely for more than three years. All of the patients were over 40 years of age. The sexes were almost equally affected. The thoracic nerves were involved most frequently, and the trigeminal nerves next. Five patients with trigeminal involvement were treated with thiamine hydrochloride, nicotinic acid, tincture of belladonna, and phenobarbital, but only one was benefited. Six patients with involvement of the thoracic nerves were treated with the same medication, with significant improvement lasting several months in one case. Intradermal injections of procaine or saline solution, peripheral neurectomies, procaine and alcohol blocks, skin excision, skin undercutting, roentgen ray therapy, posterior rhizotomy, chordotomy, lobotomy, spinal anesthesia, intrathecally administered alcohol, and paravertebral sympathetic block by means of procaine gave varied results. This experience has led to a policy of selecting a surgical operation with low morbidity as the initial step and proceeding to another if the first fails.