Clinical Efficacy of Short-Term Peripheral Nerve Stimulation in Management of Facial Pain Associated With Herpes Zoster Ophthalmicus.

Rui Han,Haocheng Zhou,Gangwen Guo,Ziyang Wang,Jianping Zhang,Yuncheng Ni,Rong Hu,Xuelian Li,Liuqing Yang,Dong Huang

doi:10.3389/fnins.2020.574713

Rui Han, Haocheng Zhou + Show 8 more

Open Access

https://doi.org/10.3389/fnins.2020.574713

Copy DOI

Abstract

ObjectivePeripheral nerve stimulation may be an alternative option to treat severe facial pain. We assessed the application of peripheral nerve stimulation for pain management in patients with herpes zoster ophthalmicus.MethodA retrospective analysis was conducted in patients suffering severe facial pain caused by ophthalmic herpetic lesions. We identified the change in pain severity before and after peripheral nerve stimulation for up to 12 months.ResultsEighteen patients were enrolled. Their mean age was 70.8 ± 9.5 years. Fifteen patients presented with subacute pain for 1–3 months, and three patients suffered postherpetic neuralgia. Dramatic relief from pain was achieved in 83% of patients (15 out of 18) upon initial removal of the stimulator, with pain reduction of > 50%. The long-term analgesic effect was reported at the 6- and 12-month follow-ups, with reductions in the visual analog scale of 4.8 ± 1.2 (n = 18) and 5.4 ± 1.4 (n = 11), respectively. The prevalence of postherpetic neuralgia was 7% (1 out of 15) in the subacute pain group. No obvious adverse effect was observed.ConclusionPeripheral nerve stimulation may be an efficacious and safe approach for pain control in patients with herpes zoster ophthalmicus.

Highlights

Herpes zoster ophthalmicus (HZO) is a viral disease associated with the first branch of the trigeminal nerve [i.e., ophthalmic nerve (V1)]
The incidence of postherpetic neuralgia (PHN, which is defined as a persistent neuropathic pain condition) is much higher with ophthalmic involvement (Coen et al, 2006)
The evaluation of patient medical records was approved by the ethics board of the Third Xiangya Hospital of Central South University (Changsha, China)

Summary

Introduction

Herpes zoster ophthalmicus (HZO) is a viral disease associated with the first branch of the trigeminal nerve [i.e., ophthalmic nerve (V1)]. It has been estimated that about 10–20% of herpetic infections affect V1 (Liesegang, 2008). HZO prevalence has increased 3.6% per year in the last two decades in the United States (Kong et al, 2020). Patients suffer severe facial pain in the distribution. PNS for HZO Pain Management of the ophthalmic division. The incidence of postherpetic neuralgia (PHN, which is defined as a persistent neuropathic pain condition) is much higher with ophthalmic involvement (Coen et al, 2006). The chronicity of the disease results in ongoing treatment in ∼20% of HZO patients (Tran et al, 2016)

Results

Discussion

Conclusion