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Prognostic clinical signs in herpes zoster pain
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THE CORRELATION OF THERMOGRAPHY AND DIAGNOSIS AT INITIAL ASSESSMENT OF THE CHKQNIC PAIN PATIENT. A.J. Clark,
P.G. Houlton, I.E. Purkis, and R.C. Shukla, Department of Anaesthesia, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia, Canada, B3H 2Y9. Aim of Investigation: Thermography has been demonstrated to be useful in the diagnosis and management of chronic pain syndromes. This study examines the correlation of liquid crystal thermography,performed as part of the initial assessment, with the initial working diagnosis. The usefulness of thermography in adding additional information is also examined. Methods: Eighty-seven patients (44 males, 43 females) referred to an out-t Pain Management Unit underwent assessment consisting of interview, examination and review of previous investigations. A diagnosis was made at the initial interview. Subsequently liquid crystal thermography was performed and interpreted. The correlation between initial diagnosis and thermography findings was assessed. Results: The average age of males was 38.7 years (range 20-59) and of females was 42.1 years (range 22-65). 75% (33/44) of thermograms obtained from males and 72% (31/43) of those obtained from females were in agreement with the initial diagnosis. 15% (7/44) of thermograms in males and 13% (6/43) in females added further information. 36% (4/11) of the thermograms that did not correlate with the initial diagnosis in males suggested a diagnosis not initially suspected. In females the figure was 41% (5/12). Conclusions: Thermography is shown to have a relatively high correlation with initial diagnosis at assessment in a group of unselected chronic pain patients. Where the correlation was negative, a different diagnosis was suggested in 39% (g/23) of patients and subsequently confirmed.
PROGNOSTIC CLINICAL SIGNS IN HERPES ZOSTER PAIN. B. Noda, K. Dan, H. Manabe and K. Higa Department of Anesthesiology,School of Medicine, Fukuoka Universitv. Fukuoka 814-01. JAPAN Aim and Methods of Investigation:It is not easy to estimate the duratior of herpetic pain or resulting the postherpetic neuralgia in the early stage of treatment for herpes zoster. We investigate the grade and spread of hypesthesia and hyperesthesia in 50 Japanese patients with early stage of treatment for herpetic pain (within 2 weeks after the initiation of skin eruption).For sensory test of eruptive skin fields, alcohol sponge (80%) was used. The normal opposite side skin in the same innervated level was tested as a control. Hypesthesia was graded from 0 to 10 when compared to normal skin (score 10). The grade and the spread of hypesthesia and hyperesthesia on the whole dermatomes of the eruptive fields were checked as often a; possible, and these findings were compared with the duration of nerve block treatment for herpetic pain. Results and Conclusion: Hypesthesia on eruptive fields was noted in 43 (86%) out of 50 herpetic pain patients, 4 out of the 43 patients complained hyperesthesia.Only hyperesthesia was noted in 2, normal sensory on the eruptive fields revealed in 5 patients (10%). 35 out of the 43 patients were hypesthetic on the whole regions of a unilateral dermatome. These 43 patients were devided into 3 groups by the grades of hypesthesia.Severe (O-3/10) hypesthesia were found in 11 (26%), moderate (4-6/10) were in 19 (44%) and slight (7-9/10)were in 13 (30%). Mean therapeutic duration for patients with severe hypesthesia was 60 days, 28 days for moderate, 17 days for patients with slight hypesthesia and 11 days for patients without hypesthesia in the treatment of herpetic pain. Therapeutic days between the severe and the each of other three groups were statistically significant (p
THE CORRELATION OF THERMOGRAPHY AND DIAGNOSIS AT INITIAL ASSESSMENT OF THE CHKQNIC PAIN PATIENT. A.J. Clark,
P.G. Houlton, I.E. Purkis, and R.C. Shukla, Department of Anaesthesia, Dalhousie University and Victoria General Hospital, Halifax, Nova Scotia, Canada, B3H 2Y9. Aim of Investigation: Thermography has been demonstrated to be useful in the diagnosis and management of chronic pain syndromes. This study examines the correlation of liquid crystal thermography,performed as part of the initial assessment, with the initial working diagnosis. The usefulness of thermography in adding additional information is also examined. Methods: Eighty-seven patients (44 males, 43 females) referred to an out-t Pain Management Unit underwent assessment consisting of interview, examination and review of previous investigations. A diagnosis was made at the initial interview. Subsequently liquid crystal thermography was performed and interpreted. The correlation between initial diagnosis and thermography findings was assessed. Results: The average age of males was 38.7 years (range 20-59) and of females was 42.1 years (range 22-65). 75% (33/44) of thermograms obtained from males and 72% (31/43) of those obtained from females were in agreement with the initial diagnosis. 15% (7/44) of thermograms in males and 13% (6/43) in females added further information. 36% (4/11) of the thermograms that did not correlate with the initial diagnosis in males suggested a diagnosis not initially suspected. In females the figure was 41% (5/12). Conclusions: Thermography is shown to have a relatively high correlation with initial diagnosis at assessment in a group of unselected chronic pain patients. Where the correlation was negative, a different diagnosis was suggested in 39% (g/23) of patients and subsequently confirmed.
PROGNOSTIC CLINICAL SIGNS IN HERPES ZOSTER PAIN. B. Noda, K. Dan, H. Manabe and K. Higa Department of Anesthesiology,School of Medicine, Fukuoka Universitv. Fukuoka 814-01. JAPAN Aim and Methods of Investigation:It is not easy to estimate the duratior of herpetic pain or resulting the postherpetic neuralgia in the early stage of treatment for herpes zoster. We investigate the grade and spread of hypesthesia and hyperesthesia in 50 Japanese patients with early stage of treatment for herpetic pain (within 2 weeks after the initiation of skin eruption).For sensory test of eruptive skin fields, alcohol sponge (80%) was used. The normal opposite side skin in the same innervated level was tested as a control. Hypesthesia was graded from 0 to 10 when compared to normal skin (score 10). The grade and the spread of hypesthesia and hyperesthesia on the whole dermatomes of the eruptive fields were checked as often a; possible, and these findings were compared with the duration of nerve block treatment for herpetic pain. Results and Conclusion: Hypesthesia on eruptive fields was noted in 43 (86%) out of 50 herpetic pain patients, 4 out of the 43 patients complained hyperesthesia.Only hyperesthesia was noted in 2, normal sensory on the eruptive fields revealed in 5 patients (10%). 35 out of the 43 patients were hypesthetic on the whole regions of a unilateral dermatome. These 43 patients were devided into 3 groups by the grades of hypesthesia.Severe (O-3/10) hypesthesia were found in 11 (26%), moderate (4-6/10) were in 19 (44%) and slight (7-9/10)were in 13 (30%). Mean therapeutic duration for patients with severe hypesthesia was 60 days, 28 days for moderate, 17 days for patients with slight hypesthesia and 11 days for patients without hypesthesia in the treatment of herpetic pain. Therapeutic days between the severe and the each of other three groups were statistically significant (p