Ozone Therapy for Post-Herpetic Neuralgia

Author Heinz Konrad, M.D.
Publication Largo Como 330, 04922-130 São Paulo, Brazil
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Ozone Therapy for Post-Herpetic Neuralgia
A retrospective study of 55 cases

Abstract

This study evaluates the outcome of ozone therapy given to 55 patients suffering from post-herpetic neuralgia, for whom “conventional” therapies brought  no relief. The author makes several considerations regarding the assessment of pain, the details of ozone therapy, the coadjuvant medication, and the criteria for the evaluation of the results, i.e. the reduction or elimination of pain. From the statistical data the author concludes that ozone therapy is an effective therapeutic approach for post-herpetic  neuralgia,  especially when all other  so-called “conventional” methods have failed.

Introduction

Post-herpetic neuralgia ( PHN ) is one of the most challenging types of pain one can be confronted with. The results of “conventional” therapy are normally rather poor.  About 20% of Herpes zoster patients can be expected to develop PHN. This percentage will be higher for patients who are older, and/or diabetic, and/or immune-deficient. Patients normally have great difficulty to understand the fact that such pain can exist even after the skin lesions have long disappeared. Also, as successive therapeutic approaches result in no alleviation of their pain, patients become more and more restive, more and more incredulous about any new approach, hopeless, and often resigned.

As to the pathogenesis of Herpes zoster, the presently prevailing theory is the reactivation of Varicella-Zoster viral units, which had remained incubated and inert in sensitive spinal ganglion(s) or Trigeminal ganglion(s) ever since the patient’s Varicella disease during childhood.

Presently, there seems to be at least one consensus : the earlier the intensive treatment of Herpes zoster is started, with whatever therapeutical method, the greater the chance  of avoiding or at least minimizing the PHN. Also, it seems that the following facts lead to expect a more severe PHN : stronger pain during the prodromic phase of Herpes zoster, stronger pain during the acute phase of H. zoster, more severe cutaneous lesions during H. zoster, and sensitive deficit within the affected dermatome already during the acute phase of H. zoster.

The most frequently affected areas are : one hemi-thorax, superior branch of one Trigeminal nerve, middle branch of one Trigeminal nerve.

The anatomical structures which are normally affected by Herpes zoster are : skin, peripheral nerve trajectories, sensitive ganglions, nerve roots, and less frequently medulla and brainstem. Histologically, one will find inflammatory reaction