Acute herpetic neuralgia and postherpetic neuralgia in the head and neck: Response to gabapentin in five cases

Background and Objectives. The clinical presentations and pharmacologic management of three patients with acute herpetic neuralgia (AHN) and two patients with postherpetic neuralgia (PHN), confined to the head and neck region, are described. Methods. Two patients had pain in the ophthalmic division of the trigeminal nerve, two had pain confined to the C2-C4 dermatomes, and one patient had C2 pain with radiating and referred pain to the second and third divisions of the trigeminal nerve. Results. Gabapentin, an anticonvulsant drug, was effective in treating these patients, including the two cases of AHN. All patients reported complete pain relief after titration with gabapentin up to 1,800 mg/d. The patients noted a dose- dependent decrease in pain almost immediately after starting gabapentin. Specifically, reduction in the frequency and intensity of allodynia, burning pain, shooting pain, and throbbing pain were noted. None of the patients experienced side effects from the drug. Conclusions. In view of the results in these patients, blinded, controlled studies are needed to determine the efficacy of gabapentin for treating AHN and PHN.