Kihara Takeshi, Shimohama Shun
Department of Neuroscience for Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida-Shimoadachi-cho 46-29, Sakyo-ku, Kyoto 606-8501, Japan.
Headache. 2006 Nov-Dec;46(10):1590-1. doi: 10.1111/j.1526-4610.2006.00616_2.x.
Occipital neuralgia is a pain syndrome which may usually be induced by spasms of the cervical muscles or trauma to the greater or lesser occipital nerves. We report a patient with occipital neuralgia followed by facial herpes lesion. A 74-year-old male experienced sudden-onset severe headache in the occipital area. The pain was localized to the distribution of the right side of the greater occipital nerve, and palpation of the right greater occipital nerve reproduces the pain. He was diagnosed with occipital neuralgia according to ICHD-II criteria. A few days later, the occipital pain was followed by reddening of the skin and the appearance, of varying size, of vesicles on the right side of his face (the maxillary nerve and the mandibular nerve region). This was diagnosed as herpes zoster. This case represents a combination of facial herpes lesions and pain in the C2 and C3 regions. The pain syndromes can be confusing, and the classic herpes zoster infection should be considered even when no skin lesions are established.
枕神经痛是一种疼痛综合征，通常可能由颈部肌肉痉挛或枕大神经或枕小神经受创伤引起。我们报告一例枕神经痛后出现面部疱疹病变的患者。一名74岁男性在枕部区域突然出现严重头痛。疼痛局限于枕大神经右侧的分布区域，触诊右侧枕大神经会再次引发疼痛。根据国际头痛疾病分类第二版（ICHD-II）标准，他被诊断为枕神经痛。几天后，枕部疼痛之后，他面部右侧（上颌神经和下颌神经区域）皮肤发红，并出现大小不等的水疱。这被诊断为带状疱疹。该病例代表了面部疱疹病变与C2和C3区域疼痛的组合。疼痛综合征可能令人困惑，即使没有明确的皮肤病变，也应考虑经典的带状疱疹感染。
