title: Postherpetic neuralgia involving the right C5 dermatome treated with a cervical transforaminal epidural steroid injection: a case report.
abstract: 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.
authors.affiliation: Western Reserve Spine and Pain Institute, Kent, OH 44240, USA. docshakir@hotmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Shakir
authors.forename: Dale A
authors.initials: DA
authors.lastname: Kimbrough
authors.forename: Bina
authors.initials: B
authors.lastname: Mehta
mesh_terms: 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*
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone