Short-term peripheral nerve stimulation or pulsed radiofrequency in elderly patients with acute herpes zoster ophthalmicus: multi-center retrospective study.

BACKGROUND

Elderly patients with herpes zoster ophthalmicus (HZO) have a high risk to progress to postherpetic neuralgia (PHN). Thus, early implementation of optimal treatment could lower the prevalence of PHN.

METHODS

We collected 50 elderly acute HZO patients treated with short-term peripheral nerve stimulation (PNS) or supraorbital nerve pulsed radiofrequency (PRF) from three hospitals from October 2022 to October 2023. All patients completed 12-month follow-up. The Visual Analog Scale (VAS), Barrow Neurological Institute (BNI) score and Pittsburgh Sleep Quality Index (PSQI) were used to assess the pain intensity and sleep quality.

RESULTS

The pain intensity and sleep quality of all patients was significantly relieved after surgery. Following surgery, the PNS group's VAS and PSQI scores were statistically lower than those of the PRF group, and they also took less medication. At 3 months after surgery, the incidence of clinically significant PHN in the PNS group was lower than the PNS group. At 12 months after surgery, the BNI scores of the PNS group were better than the PRF group.

CONCLUSIONS

Early application of short-term PNS or PRF for acute-phase HZO in the elderly can relieve pain. Compared to PRF, PNS may offer superior pain management, enhance quality of life, and contribute to a downward trend in the incidence of PHN.