Intrathecal Dexamethasone For The Treatment Of Intractable Postherpetic Neuralgia: A Case Report

Postherpetic neuralgia (PHN) is a debilitating chronic pain condition that affects approximately 25% of patients after herpes zoster infection. Despite many pharmacologic treatments for PHN, some patients continue to suffer from intractable pain. Intrathecal administration of methylprednisolone has been reported to be an effective treatment for PHN. We describe our first successful case of treating intractable PHN in a 73 year-old patient after three consecutive weekly intrathecal administration of dexamethasone. He failed to obtain pain relief with drug therapy including antidepressants, anticonvulsants and opioids. At six months follow up, patient continued to have good symptom relief with 70% reduction in pain and resolution of allodynia.