Elderly patient with post-herpetic neuralgia treated with homoeopathic medicine: A case report

Abstract

Introduction: Post-herpetic neuralgia (PHN) is the most troublesome complication of herpes zoster (HZ). It often occurs in elderly and immunocompromised persons. PHN is a chronic neuropathic pain that can persist months to years after HZ rashes have healed. The persisting pain causes physical and psychological distress and negatively impacts the quality of life. The conventional method of treatment (CMT) is often only partially effective. In patients with inadequate response, or intolerance to current conventional treatments for pain relief, homoeopathy may be considered. Case Summary: A 64-year-old woman presented with severe neuralgic pain on the right upper chest wall and upper arm with a recent history of HZ. The acute neuralgic pain was accompanied with HZ rashes. Within 1 month of CMT, HZ healed, but neuralgic pain persisted. Homoeopathic medicines Hypericum perforatum and Sulphur were prescribed as per the totality of symptoms and individualisation, which relieved PHN (assessed by ‘Visual Analogue Scale’ [VAS]). It was accompanied with relief in associated symptoms and improvement in functional daily activities. The causal attribution of the improvement was assessed using the Modified Naranjo Criteria. This case report suggests that homoeopathic intervention may be the choice of treatment for relief of pain of PHN along with improvement in the psychological distress and quality of life.