BACKGROUND AND OBJECTIVES: Herpes-zoster (HZ) is a vesicular painful skin rash resulting from the reactivation of vari cella-zoster virus (VZV) in dorsal root ganglia or cranial nerves, which occurs decades after the primary varicella infection. However, even after skin healing, pain may persist for months or even years. This is a complication known as post-herpetic neuralgia (PHN). This review aimed at giving an overview of herpes-zoster and PHN clinical history, focusing on pain control. CONTENTS: PHN is characterized by chronic neuropathic pain. Its incidence is higher among the elderly and immunocompromised individuals. There are several treatment options, which may be pharmacological or interventionist, both with variable efficacy. CONCLUSION: Pain affects quality of life of patients, interfering with their daily activities. In spite of advances already obtained in the analgesic therapy for HZ and PHN, there are still difficulties in its approach. So, it is very important to prevent, diagnose and early treat HZ and its complications.
Objetivos: apresentar um caso de sintomas neurológicos transitórios (SNT) de duração e apresentação pouco habitual em paciente submetida à apendicectomia sob raquianestesia. Relato de Caso: paciente feminina, 44 anos, submetida à raquianestesia para realização de apendicectomia. Referiu intensa sensação de choque no pé direito durante realização do bloqueio anestésico e evoluiu no pós-operatório imediato com quadro de dor, de moderada intensidade, de padrão neuropático em pé direito (dermátomo S1), além de disfunção esfincteriana. Realizou-se investigação com ressonância nuclear magnética de coluna lombar e eletroneuromiografia de membros inferiores, descartando-se etiologia infecciosa e vascular, sendo provável a causa de trauma durante a inserção da agulha de punção. O tratamento incluiu uso de antidepressivo tricíclico, corticoide e gabapentinoide com regressão completa da sintomatologia, porém lenta, num período de 3 meses. Conclusão: apesar do desfecho favorável na maioria dos casos de SNT, medidas de prevenção devem ser adotadas para evitar tal complicação neurológica, tais como técnica anestésica adequada, correto posicionamento na mesa cirúrgica, medidas para evitar hipotensão prolongada e isquemia neural.
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