Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review
AbstractBackground Effective pain control of herpes zoster ophthalmicus (HZO) is not only essential to attenuate the clinical symptoms but to reduce the risk of postherpetic neuralgia development. Recently, neuromodulation therapy has been one promising option for neuropathic pain and increasingly a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2023.2288826 |
| _version_ | 1797302156248743936 |
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| author | Jiahui Ma Yaling Wan Liuqing Yang Dong Huang Haocheng Zhou |
| author_facet | Jiahui Ma Yaling Wan Liuqing Yang Dong Huang Haocheng Zhou |
| author_sort | Jiahui Ma |
| collection | DOAJ |
| description | AbstractBackground Effective pain control of herpes zoster ophthalmicus (HZO) is not only essential to attenuate the clinical symptoms but to reduce the risk of postherpetic neuralgia development. Recently, neuromodulation therapy has been one promising option for neuropathic pain and increasingly applied in management of zoster-related pain. One key factor of neuromodulation treatment is the therapeutic site for the impaired nerves. In this study we aim to investigate one novel dual-neuromodulation strategy, targeting the level of the peripheral branch and trigeminal ganglion, in the pain management of HZO.Methods Dual neuromodulation strategy combining short-term peripheral nerve stimulation (PNS) with pulsed radiofrequency (PRF) of trigeminal ganglion was compared with single PNS treatment for HZO-related pain. Clinical recordings of patients were retrospectively reviewed. The primary outcome was the pain severity, assessed by the visual analogue scale (VAS) before and after neuromodulation therapy.Results PNS achieved significant relief of pain with or without PRF treatment before discharge, which provided enduring therapeutic effect up to 12-month follow-up. The mean reduction of VAS was 6.7 ± 1.4 in dual modulation therapy (n = 13) at last follow-up and 5.4 ± 1.5 in PNS subgroup (n = 20), respectively. Moreover, dual modulation strategy provided better control of pain compared with PNS therapy alone at each time point.Conclusion It is feasible and effective to combine the PNS and PRF in pain management of HZO. This novel dual modulation strategy of trigeminal pathway may provide additional therapeutic effects of pain symptoms in HZO population. |
| first_indexed | 2024-03-07T23:32:47Z |
| format | Article |
| id | doaj.art-8e962e85cbc34dcebe62ff4a817cfb76 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-07T23:32:47Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-8e962e85cbc34dcebe62ff4a817cfb762024-02-20T11:58:25ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602023-12-0155210.1080/07853890.2023.2288826Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature reviewJiahui Ma0Yaling Wan1Liuqing Yang2Dong Huang3Haocheng Zhou4Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, ChinaDepartment of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, ChinaDepartment of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, ChinaDepartment of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, ChinaDepartment of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, ChinaAbstractBackground Effective pain control of herpes zoster ophthalmicus (HZO) is not only essential to attenuate the clinical symptoms but to reduce the risk of postherpetic neuralgia development. Recently, neuromodulation therapy has been one promising option for neuropathic pain and increasingly applied in management of zoster-related pain. One key factor of neuromodulation treatment is the therapeutic site for the impaired nerves. In this study we aim to investigate one novel dual-neuromodulation strategy, targeting the level of the peripheral branch and trigeminal ganglion, in the pain management of HZO.Methods Dual neuromodulation strategy combining short-term peripheral nerve stimulation (PNS) with pulsed radiofrequency (PRF) of trigeminal ganglion was compared with single PNS treatment for HZO-related pain. Clinical recordings of patients were retrospectively reviewed. The primary outcome was the pain severity, assessed by the visual analogue scale (VAS) before and after neuromodulation therapy.Results PNS achieved significant relief of pain with or without PRF treatment before discharge, which provided enduring therapeutic effect up to 12-month follow-up. The mean reduction of VAS was 6.7 ± 1.4 in dual modulation therapy (n = 13) at last follow-up and 5.4 ± 1.5 in PNS subgroup (n = 20), respectively. Moreover, dual modulation strategy provided better control of pain compared with PNS therapy alone at each time point.Conclusion It is feasible and effective to combine the PNS and PRF in pain management of HZO. This novel dual modulation strategy of trigeminal pathway may provide additional therapeutic effects of pain symptoms in HZO population.https://www.tandfonline.com/doi/10.1080/07853890.2023.2288826Neuromodulationpulsed radiofrequencyperipheral nerve stimulationelectrical nerve stimulationherpes zoster ophthalmicuspain |
| spellingShingle | Jiahui Ma Yaling Wan Liuqing Yang Dong Huang Haocheng Zhou Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review Annals of Medicine Neuromodulation pulsed radiofrequency peripheral nerve stimulation electrical nerve stimulation herpes zoster ophthalmicus pain |
| title | Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review |
| title_full | Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review |
| title_fullStr | Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review |
| title_full_unstemmed | Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review |
| title_short | Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review |
| title_sort | dual neuromodulation strategy in pain management of herpes zoster ophthalmicus retrospective cohort study and literature review |
| topic | Neuromodulation pulsed radiofrequency peripheral nerve stimulation electrical nerve stimulation herpes zoster ophthalmicus pain |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2023.2288826 |
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