Intrathecal steroid therapy for postherpetic neuralgia: a review
| Autor: | Dewey A. Nelson, William M. Landau |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Lidocaine Postherpetic neuralgia business.industry General Neuroscience Chronic pain Methylprednisolone acetate Intrathecal medicine.disease Therapeutic trial Surgery Steroid therapy Methylprednisolone Anesthesia medicine Pharmacology (medical) Neurology (clinical) business medicine.drug |
| Zdroj: | Expert review of neurotherapeutics. 2(5) |
| ISSN: | 1744-8360 |
| Popis: | Two recent publications advocated intrathecal injection of methylprednisolone acetate for postherpetic neuralgia. Conceptually, these therapeutic trials were based on the failed assumption that chronic inflammation persists in dorsal root ganglia even after the lesions of acute zoster have healed. Constructionally, these publications can be criticized on numerous grounds: cranial zoster was excluded, follow up periods were too short, dangers or reactivating the varicella virus were ignored, no methylprednisolone acetate-only group was included, pharmacological dangers of intrathecal lidocaine were overlooked. In addition to these basic conceptual deficiencies, multiple dangers of intrathecal methylprednisolone (therapeutically and by accidental injection) are manifest in a literature dating back over two decades in which several hundred serious complications are described. In summary, all rational eveidence indicates that this treatment should not be prescribed. |
| Databáze: | OpenAIRE |
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