title: Case report: computed tomography scan-guided Gasserian ganglion injection of dexamethasone and lidocaine for the treatment of recalcitrant pain associated with herpes simplex type 1 infection of the ophthalmic division of the trigeminal nerve.
abstract: We describe the case of a 17-year-old boy with dermatologic herpes simplex virus-1 outbreaks with incapacitating facial pain requiring multiple hospitalizations. He failed to respond to aggressive treatments including antiviral drugs, opioid analgesics, stellate ganglion, and supraorbital and supratrochlear nerve blocks. The patient elected to undergo dexamethasone and lidocaine Gasserian ganglion block under computed tomography-scan guidance. He had immediate and complete relief of his pain for the first time in almost 2 years. The patient remained pain free during 6-month follow-up visits. This is the first reported use of Gasserian ganglion block for treatment of herpes simplex virus-1 infection of the trigeminal nerve.
authors.affiliation: Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 West Wellington Avenue, Suite 4815, Chicago, IL 60657, USA. kdcandido@yahoo.com
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Candido
authors.forename: Andrew
authors.initials: A
authors.lastname: Germanovich
authors.forename: Ramsis F
authors.initials: RF
authors.lastname: Ghaly
authors.forename: Gleb H
authors.initials: GH
authors.lastname: Gorelick
authors.forename: Nebojsa Nick
authors.initials: NN
authors.lastname: Knezevic
mesh_terms: D000293:Adolescent; D003907:Dexamethasone / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018259:Herpesvirus 1, Human; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D010146:Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D012668:Trigeminal Ganglion / Q000000981:diagnostic imaging / Q000187:drug effects*; D014277:Trigeminal Neuralgia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology
chemical_list: D003907:Dexamethasone; D008012:Lidocaine