Trigeminal neuralgia secondary to herpes zoster

Background: The hemicrania herpes zoster with trigeminal nerve affection is due to the virus reactivation of the chickenpox in patients with chickenpox history and risk or predisposing factors. Acute pain may be alleviated spontaneously, but the infection sequela may persist. Chronic pain, known as postherpetic neuralgia, may appear in 15% of patients. It affects trigeminal nerve in second and third branches, it is rare in the first one and, in general, it is not bilateral. Objective: To evaluate effectiveness of analgesic type non steroid anti-inflammatory, antidepressants and placebo, in a single patient with post-herpetic neuralgia of the first right branch of trigeminal nerve without reaction to treatment. Patient and method: Masculine of 34 years old, with positive HIV and hepatitis C. In a random clinical trial four drugs were studied by oral way: acetaminophen 250 mg, sertraline 25 mg; amitriptiline 12.5 mg and placebo c/24 h during four weeks each one. Statistical analysis: paired t Student Statistical package SPSS v 10. Microsoft Office 2003. Results: The pair placebo-amitriptilina, 1.3036 with confidence interval (CI) 95% (.8166-1.7905) t=5.365 gl=55 p=0.00, pair 5 amitriptiline-sertraline, 1.1429 CI 95% (1.5805-0.7053) t 5.234 gl=55 p=0.000. Conclusions: In this patient this kind of scheme may be considered efficient to reduce trigeminal neuralgia. Results benefit amitriptiline about clinical efficacy and statistical significance.