Controlling Herpes Zoster-Associated Pain Using an Electrical Stimulating Catheter with a Steering Guidewire: A Case Series

Background: Treatment of herpes zoster not only includes antiviral therapy but also treatment of herpes zoster-associated pain. Severe herpes zoster-associated pain often limits a patient’s activities of daily living and may significantly lower functional status and quality of life. It also functions as an important predictor of postherpetic neuralgia. Thus, effective treatment of zoster pain is highly necessary. The effectiveness of a drug may depend on the method of administration, with each route having merits and limitations. Accurate epidural drug delivery directly into an affected spinal segment can maximize the effects of the drug, while minimizing systemic adverse drug effects. Here, we present three cases of successful control of zoster pain using an electrical stimulating catheter with a steering guidewire. Case Presentation: We treated three patients suffering from herpes zoster with continuous segmental block using an electrical stimulating catheter. The first case involved a 54-year old man with severe right-sided low back and thigh pain, the second patient was a 72-year-old woman suffering from multiple painful grouped vesicles on the left flank, the third patient was a 72-year-old man with multiple vesicles on the right arm. The three patients were treated with continuous segmental block via an electrical stimulating catheter, which was able to localize stimulation to the affected spinal segment. There were no procedure-related complications, and the pain levels of the patients decreased significantly. Conclusions: Continuous segmental block through electrical stimulation using an electrical stimulating catheter with a steering guidewire can be precisely positioned, providing targeted drug delivery and effective management of herpes zoster.