Earlier treatment improves the chances of complete relief from postherpetic neuralgia
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Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were 64.3 ± 10.6 and 66.9 ± 10.7 years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were 8.5 ± 6.3 and 15.3 ± 10.7 months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result. (Korean J Pain 2017; 30: 214-9)
Abstract
Background: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. Methods: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years. The responders were defined as patients who had complete relief from pain after 1 year of active treatment. Age, sex, PHN duration at their first visit, dermatomal distribution, and underlying disorders were compared in the responder and non-responder groups. Responders were also compared according to these factors. Results: Among 117 PHN patients (M/F = 48/69), 35 patients (29.9%) had complete relief from PHN. Mean ages were 64.3 ± 10.6 and 66.9 ± 10.7 years, numbers of male to female patients were 11/24 and 37/45, and mean durations of PHN at their first visit were 8.5 ± 6.3 and 15.3 ± 10.7 months in the responder and non- responder groups, respectively. In addition, PHN patients who visited the clinic before 9 months showed a better result. Dermatomal distribution and underlying disorders did not show significant differences. Conclusions: Almost 30% of PHN patients received complete relief. Those who sought treatment in a pain clinic before 9 months received a better result. (Korean J Pain 2017; 30: 214-9)
참고문헌 (14)
- De Moragas JM, "The outcome of patients with herpes zoster", AMA Arch Derm, 75, pp.193~196 (1957)
- Dworkin RH, "Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia", J Pain, 9, pp.S37~S44 (2008)
- Thakur R, "Bonica’s management of pain", pp.338~357 (2010), Lippincott Williams & Wilkins
- 김경훈, "Herpes Zoster Vaccination", The Korean Journal of Pain, 26(3), pp.242~248 (2013), 대한통증학회
- Forbes HJ, "A systematic review and meta-analysis of risk factors for postherpetic neuralgia", Pain, 157, pp.30~54 (2016)
- 양종연, "Administration of four different doses of gabapentin reduces awakening from breakthrough pain and adverse effects in outpatients with neuropathic pain during the initial titration", Korean Journal of Anesthesiology, 65(1), pp.48~54 (2013), 대한마취통증의학회
- 주영찬, "Intravenous Nefopam Reduces Postherpetic Neuralgia during the Titration of Oral Medications", The Korean Journal of Pain, 27(1), pp.54~62 (2014), 대한통증학회
- 김경훈, "Safe Sedation and Hypnosis using Dexmedetomidine for Minimally Invasive Spine Surgery in a Prone Position", The Korean Journal of Pain, 27(4), pp.313~320 (2014), 대한통증학회
- 옥영민, "Nefopam Reduces Dysesthesia after Percutaneous Endoscopic Lumbar Discectomy", The Korean Journal of Pain, 29(1), pp.40~47 (2016), 대한통증학회
- 김경훈, "Mechanical Antiallodynic Effect of Intrathecal Nefopam in a Rat Neuropathic Pain Model", Journal of Korean Medical Science, 30(8), pp.1189~1196 (2015), 대한의학회
- 김경훈, "Rediscovery of Nefopam for the Treatment of Neuropathic Pain", The Korean Journal of Pain, 27(2), pp.103~111 (2014), 대한통증학회
- Ragozzino MW, "Population-based study of herpes zoster and its sequelae", Medicine (Baltimore), 61, pp.310~316 (1982)
- Elias WJ, "Trigeminal neuralgia and other neuropathic pain syndromes of the head and face", Curr Pain Headache Rep, 6, pp.115~124 (2002)
- In Yeob Baek, "Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature", The Korean Journal of Pain, 24(3), pp.154~158 (2011), 대한통증학회