Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
Korean J Pain. 2013 Jan;26(1):76-9. doi: 10.3344/kjp.2013.26.1.76. Epub 2013 Jan 4.
During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.
在带状疱疹后神经痛的早期,受累节段的硬膜外阻滞有助于控制疼痛和防止进展为慢性状态。硬膜外阻滞后主要的神经系统并发症是由于硬膜外血肿导致的脊髓压迫症状。当硬膜外阻滞治疗带状疱疹后神经痛出现神经系统并发症时,重要的是要确定并发症是由于该操作还是由于带状疱疹本身引起。我们报告了 1 例在治疗带状疱疹后神经痛时被诊断为带状疱疹性脊髓炎的患者。该患者在接受 6 次胸椎硬膜外阻滞治疗后出现下肢运动无力。虽然最初我们认为并发症是由于硬膜外阻滞引起的,但最终确定是由带状疱疹性脊髓炎引起的。