Abstract
Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients' quality of life and frequently refractory to treatment. Here, we present a case of severe chronic PHI successfully treated with supraorbital nerve block using a high concentration of tetracaine dissolved in bupivacaine. An 82-year-old man presented with severe chronic itching in the ophthalmic branch of the left trigeminal nerve dermatome, following acute herpes zoster. The patient's itching was unresponsive to usual medical treatments for PHI including antiepileptic drugs, topical capsaicin cream, and supraorbital nerve radiofrequency thermo-coagulation. Topical lidocaine cream could relieve the itching, but could not provide long-term relief of itching and thus failed to achieve a satisfactory result. After these conventional treatments, left supraorbital nerve block using 4% tetracaine dissolved with 0.5% bupivacaine was conducted. Afterwards, the patient experienced long-lasting resolution of the itching with improvement of sleep disturbance. A transient, mild edema of the eyelids occurred, but there were no other complications. Peripheral nerve block usin...Continue Reading
References
Jan 1, 1976·Clinical Neurosurgery·W H Sweet
Feb 3, 1999·Pain·F GotoM Terada
May 26, 1999·Pain·B S GalerE Friedman
Jun 28, 2000·The Clinical Journal of Pain·S E Abram
Mar 29, 2001·Neurosurgery·Y KanpolatC Berk
Jan 11, 2002·The Clinical Journal of Pain·I A RadwanF Goto
Apr 5, 2002·Pain·Anne Louise OaklanderShubha V Y Raju
Nov 19, 2003·The Journal of Pain : Official Journal of the American Pain Society·Anne Louise OaklanderMark P Jensen
May 30, 2006·Anesthesiology·Philipp LirkPeter Gerner
Oct 9, 2007·Pain·Robert H DworkinMark S Wallace
Apr 23, 2008·The Clinical Journal of Pain·Valentina Semionov, Pesach Shvartzman
Jun 5, 2010·Current Pain and Headache Reports·Dhanalakshmi Koyyalagunta, Allen W Burton
Jun 8, 2011·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·C Potenzieri, B J Undem
Jul 20, 2011·Seminars in Cutaneous Medicine and Surgery·Sarina B Elmariah, Ethan A Lerner
Nov 30, 2012·Journal of Anesthesia·Young-Chan JooKyung-Hoon Kim
Apr 4, 2013·Nephron. Clinical Practice·Hugh RaynerIndranil Dasgupta
Dec 3, 2013·Internal Medicine·Kenjiro ImaiMitsuhiko Noda
Oct 16, 2014·The New England Journal of Medicine·Robert W Johnson, Andrew S C Rice
Feb 4, 2016·The Korean Journal of Pain·Eun Ji ChoiKyung Hoon Kim
Mar 10, 2016·International Journal of Molecular Sciences·Mark VerlindePhilipp Lirk