Postherpetic neuralgia involving the right C5 dermatome treated with a cervical transforaminal epidural steroid injection: a case report.
A 66-year-old woman presented with 2 weeks of debilitating right upper-limb pain with a vesicular rash over the right C5 dermatome secondary to herpes zoster. Her pain failed to improve with: oral narcotics, divalproex, gabapentin, pregabalin, and topical 2% lidocaine cream. Six weeks postonset, a right C5 transforaminal epidural steroid injection (TESI) under fluoroscopic guidance was performed. Prior to the injection, her numeric pain intensity was rated as 9 to 10/10, and 15 minutes after the injection, it was reduced to 3/10. At 2 weeks, her pain had maintained an intensity of 3/10 and over another 2 weeks had resolved. She remained pain-free 3 months later. In this case, the use of a cervical TESI provided dramatic results in the treatment of debilitating postherpetic neuralgia (PHN). Further investigation is needed to determine the efficacy of TESI in the early management of PHN.
Shakir
Ali
A
Western Reserve Spine and Pain Institute, Kent, OH 44240, USA. docshakir@hotmail.com
Kimbrough
Dale A
DA
Mehta
Bina
B
D000368:Aged; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007268:Injections, Epidural; D051474:Neuralgia, Postherpetic / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D014221:Triamcinolone / Q000627:therapeutic use*
D005938:Glucocorticoids; D014221:Triamcinolone