Postherpetic Neuralgia Involving the Right C5 Dermatome Treated With a Cervical Transforaminal Epidural Steroid Injection: A Case Report.
Arch Phys Med Rehabil 2007;
88:255-8. [PMID:
17270526 DOI:
10.1016/j.apmr.2006.11.001]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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.
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