Posters

Pterygopalatine ganglion blockade for pain relief in herpetic ophthalmic neuralgia. Clinical cases

Poster Details

First Author: O.Mishchenko RUSSIA

Co Author(s):    I. Oleshenko   T. Iureva                 

Abstract Details

Purpose:

To show the efficacy of the pterygopalatine ganglion blockade for the pain relief in herpetic ophthalmic neuralgia

Setting:

Irkutsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia

Methods:

Case 1. Patient, 47 years old. Pain complaints in OS (verbal pain scale (VPS=3), reduced vision. For 2 years 4 recurrencies of herpetic keratitis in OS. Pronounced edema of eyelid, blepharospasm in OU. In OS - Acyclovir 3%, NSAIDS per os. To relieve the pain, pterygopalatine ganglion blockade was performed. Сase 2. Patient, 60 years old. Blepharoptosis complaints in OS, pain (VPS=2). 2 months ago – standard phacoemulsification. Ptosis I degree, the cornea is transparent, no signs of uveitis. The condition is regarded as ganglionitis n. ophthalmicus of unclear etiology. Pterygopalatine ganglion blockade was performed.

Results:

Case 1. After the pterygopalatine ganglion blockade pain syndrome was relieved. The next day, edema of the eyelids decreased, visual acuity increased, no photophobia were noted. The patient continued standard antiherpetic therapy. Case 2. In 40 minutes after the pterygopalatine ganglion blockade pain syndrome was relieved, VPS=0. 2 hours after the blockade ptosis decreased. After 72 hours the patient had a draining herpetic rash on the skin in the projection of the III branch of the trigeminal nerve on the left. Ptosis was absent. There was no pain in OS. The infectious disease specialist continued further treatment.

Conclusions:

The pterygopalatine ganglion blockade interrupts the nociceptive efferent flow of the pathways, relieving pain. In addition, in the second clinical case, the sympathetic block interrupted the spread of herpetic infection along the I and II branches of the trigeminal nerve. In addition, a decrease in perineural edema led to the relief of blepharoptosis.

Financial Disclosure:

None