Cargando…

Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report

BACKGROUND: Ramsay Hunt syndrome (RHS) is caused by a reactivation of varicella-zoster virus (VZV) infection, and it is characterized by the symptoms of facial paralysis, otalgia, auricular rash, and/or an oral lesion. Elderly patients or immunocompromised patients, deep pain at the initial visit an...

Descripción completa

Detalles Bibliográficos
Autores principales: Liao, Yuan-Mei, Lu, Hai-Feng, Xie, Peng, Zhao, Ying, Han, Qiu, Zhang, Qian-Xi, Zuo, Xiao-Hua, Si, Yan-Na, Bao, Hong-Guang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840788/
https://www.ncbi.nlm.nih.gov/pubmed/33509130
http://dx.doi.org/10.1186/s12883-021-02071-5
_version_ 1783643653087952896
author Liao, Yuan-Mei
Lu, Hai-Feng
Xie, Peng
Zhao, Ying
Han, Qiu
Zhang, Qian-Xi
Zuo, Xiao-Hua
Si, Yan-Na
Bao, Hong-Guang
author_facet Liao, Yuan-Mei
Lu, Hai-Feng
Xie, Peng
Zhao, Ying
Han, Qiu
Zhang, Qian-Xi
Zuo, Xiao-Hua
Si, Yan-Na
Bao, Hong-Guang
author_sort Liao, Yuan-Mei
collection PubMed
description BACKGROUND: Ramsay Hunt syndrome (RHS) is caused by a reactivation of varicella-zoster virus (VZV) infection, and it is characterized by the symptoms of facial paralysis, otalgia, auricular rash, and/or an oral lesion. Elderly patients or immunocompromised patients, deep pain at the initial visit and no prompt treatment are significant predictors of postherpetic neuralgia (PHN). When PHN occurs, especially involved cranial polyneuropathy, multiple modalities should be administered for patients with the intractable PHN. The use of thermography in the follow-up of PHN secondary to RHS with multicranial nerve involvement has not yet been described yet in the literature. CASE PRESENTATION: The patient was a 78-year-old man with the chief complaint of a 3-month history of PHN secondary to RHS with polycranial nerve (V, VII, VIII, and IX) involvement. Multimodality therapy with oral gabapentin, pulsed radiofrequency (PRF) application to the Gasserian ganglion for pain in the trigeminal nerve region, linear-polarized near-infrared light irradiation for pain in the facial nerve region, and 2% lidocaine spray for pain in the glossopharyngeal nerve region was used to the treat patient, and follow-up evaluations included thermography. This comprehensive treatment obviously improved the quality of life, resulting in considerable pain relief, as indicated by a decrease in the numerical rating scale (NRS) score from 9 to 3 and a decrease in thermal imaging temperature from higher to average temperature on the ipsilateral side compared with the contralateral side. Lidocaine spray on the tonsillar branches of the glossopharyngeal nerve resulted in an improvement in odynophagia, and the NRS score decreased from 9 to 0 for glossopharyngeal neuralgia after three applications. CONCLUSION: Although the use of thermography in the follow-up of RHS with multiple cranial nerve (V, VII, VIII, and IX) involvement is very rare, in this patient, thermal imaging showed the efficacy of combination therapy (oral gabapentin, 2% lidocaine sprayed, PRF application and linear-polarized near-infrared light irradiation) and that is a good option for treatment.
format Online
Article
Text
id pubmed-7840788
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-78407882021-01-28 Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report Liao, Yuan-Mei Lu, Hai-Feng Xie, Peng Zhao, Ying Han, Qiu Zhang, Qian-Xi Zuo, Xiao-Hua Si, Yan-Na Bao, Hong-Guang BMC Neurol Case Report BACKGROUND: Ramsay Hunt syndrome (RHS) is caused by a reactivation of varicella-zoster virus (VZV) infection, and it is characterized by the symptoms of facial paralysis, otalgia, auricular rash, and/or an oral lesion. Elderly patients or immunocompromised patients, deep pain at the initial visit and no prompt treatment are significant predictors of postherpetic neuralgia (PHN). When PHN occurs, especially involved cranial polyneuropathy, multiple modalities should be administered for patients with the intractable PHN. The use of thermography in the follow-up of PHN secondary to RHS with multicranial nerve involvement has not yet been described yet in the literature. CASE PRESENTATION: The patient was a 78-year-old man with the chief complaint of a 3-month history of PHN secondary to RHS with polycranial nerve (V, VII, VIII, and IX) involvement. Multimodality therapy with oral gabapentin, pulsed radiofrequency (PRF) application to the Gasserian ganglion for pain in the trigeminal nerve region, linear-polarized near-infrared light irradiation for pain in the facial nerve region, and 2% lidocaine spray for pain in the glossopharyngeal nerve region was used to the treat patient, and follow-up evaluations included thermography. This comprehensive treatment obviously improved the quality of life, resulting in considerable pain relief, as indicated by a decrease in the numerical rating scale (NRS) score from 9 to 3 and a decrease in thermal imaging temperature from higher to average temperature on the ipsilateral side compared with the contralateral side. Lidocaine spray on the tonsillar branches of the glossopharyngeal nerve resulted in an improvement in odynophagia, and the NRS score decreased from 9 to 0 for glossopharyngeal neuralgia after three applications. CONCLUSION: Although the use of thermography in the follow-up of RHS with multiple cranial nerve (V, VII, VIII, and IX) involvement is very rare, in this patient, thermal imaging showed the efficacy of combination therapy (oral gabapentin, 2% lidocaine sprayed, PRF application and linear-polarized near-infrared light irradiation) and that is a good option for treatment. BioMed Central 2021-01-28 /pmc/articles/PMC7840788/ /pubmed/33509130 http://dx.doi.org/10.1186/s12883-021-02071-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Liao, Yuan-Mei
Lu, Hai-Feng
Xie, Peng
Zhao, Ying
Han, Qiu
Zhang, Qian-Xi
Zuo, Xiao-Hua
Si, Yan-Na
Bao, Hong-Guang
Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title_full Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title_fullStr Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title_full_unstemmed Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title_short Thermographic follow-up of postherpetic neuralgia (PHN) subsequent to Ramsay Hunt syndrome with multicranial nerve (V, VII, VIII and IX) involvement: a case report
title_sort thermographic follow-up of postherpetic neuralgia (phn) subsequent to ramsay hunt syndrome with multicranial nerve (v, vii, viii and ix) involvement: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840788/
https://www.ncbi.nlm.nih.gov/pubmed/33509130
http://dx.doi.org/10.1186/s12883-021-02071-5
work_keys_str_mv AT liaoyuanmei thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT luhaifeng thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT xiepeng thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT zhaoying thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT hanqiu thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT zhangqianxi thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT zuoxiaohua thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT siyanna thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport
AT baohongguang thermographicfollowupofpostherpeticneuralgiaphnsubsequenttoramsayhuntsyndromewithmulticranialnervevviiviiiandixinvolvementacasereport