Abstract
Introduction: Approximately 12.5% of patients with herpes zoster (HZ) > 50 years old suffer from post-herpetic neuralgia (PHN) 3 months after the outbreak, finding that approximately 50% of these cases don’t present pain relief with pharmacotherapy which in the long term is associated with adverse effects, negatively affecting their quality of life which could benefit from interventional therapies.
Case presentation: 70-year-old female with a history of HZ in 2013 with involvement of right V1 of the trigeminal, with development of NPH. Multiple oral treatments, subcutaneous applications of lidocaine with poor pain modulation for 10 years. Initial visual analog pain scale (VAS): 10/10. Botulinum toxin type A (BTX-A) is applied with follow-up at 4 weeks with VAS 0/10, 12 weeks VAS 2/10, with improvement in sleep and quality of life.
Discussion: Current studies demonstrate that BTX-A is more effective than lidocaine for PHN according to VAS scores at one, two and three months, which coincides with the present clinical case. Additionally, it was significantly more effective than other therapies, except for combined interventional therapies. BTX-A has not been associated with any serious adverse events.
Conclusions: BTX-A induces a significant reduction in pain (30-50% of VAS) for a maximum of 3-4 months per injection cycle, which coincides with the results of this case report, which suggests that the application of BTX-A is a tolerable, safe and effective therapeutic alternative.
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