Wang Huan, Hu Yu-Zhong, Che Xian-Wei, Yu Liang
Department of Anesthesiology, Zhejiang Chinese Medicine University, Hangzhou 310000, Zhejiang Province, China.
Transcranial Magnetic Stimulation Centre, Deqing Hospital of Hangzhou Normal University, Hangzhou 310000, Zhejiang Province, China.
World J Clin Cases. 2023 Mar 26;11(9):2015-2020. doi: 10.12998/wjcc.v11.i9.2015.
Postherpetic neuralgia (PHN) is a typical neuropathic pain condition that appears in the lesioned skin regions following the healing of shingles. The pain condition tends to persist, which is often accompanied by negative emotions ( anxiety and depression) and substantially reduces the quality of life. In addition to analgesia ( pregabalin and gabapentin), nerve radiofrequency technology is an effective treatment for intractable PHN. However, there is still a significant portion of patients who do not benefit from this treatment. As a non-invasive form of brain stimulation, repetitive transcranial magnetic stimulation (rTMS) targeting the motor cortex is able to reduce neuropathic pain with grade A evidence.
Here we report two cases in which motor cortex rTMS was used to treat intractable PHN that did not respond to initial drug and radiofrequency therapies. Moreover, we specifically investigated rTMS efficacy at 3 mo following treatment.
Motor cortex rTMS can treat intractable PHN that did not respond to initial drug and radiofrequency therapies.
带状疱疹后神经痛（PHN）是一种典型的神经性疼痛疾病，出现在带状疱疹愈合后的皮损区域。这种疼痛往往持续存在，常伴有负面情绪（焦虑和抑郁），并严重降低生活质量。除了镇痛治疗（普瑞巴林和加巴喷丁）外，神经射频技术是治疗顽固性PHN的有效方法。然而，仍有相当一部分患者无法从这种治疗中获益。作为一种非侵入性脑刺激形式，针对运动皮层的重复经颅磁刺激（rTMS）能够减轻神经性疼痛，证据等级为A级。
在此我们报告两例使用运动皮层rTMS治疗对初始药物和射频治疗无效的顽固性PHN的病例。此外，我们特别研究了治疗后3个月时rTMS的疗效。
运动皮层rTMS可治疗对初始药物和射频治疗无效的顽固性PHN。
