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Postherpetic neuralgia involving the right C5 dermatome treated with a cervical transforaminal epidural steroid

Ali Shakir1, Dale A Kimbrough, Bina Mehta

  • 1Western Reserve Spine and Pain Institute, Kent, OH 44240, USA. docshakir@hotmail.com

Archives of Physical Medicine and Rehabilitation
|February 3, 2007
PubMed

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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