27 May 2026
: Case report 
Targeting Neuroinflammation and Peripheral Nerve Dysfunction in Refractory Postherpetic Neuralgia: A Multimodal Injection Case Series
Unusual setting of medical care, Educational Purpose (only if useful for a systematic review or synthesis)
Grady Janitra ABCDEF 1, Dedi Susila
ABCDEFG 1,2*, Liong Liem ACF 3
DOI: 10.12659/AJCR.951991
Am J Case Rep 2026; 27:e951991
Table 1 Demographic characteristics, pain location, treatment history, and pain evaluation outcomes in 4 patients with postherpetic neuralgia.
| Characteristic | Case 1 | Case 2 | Case 3 | Case 4 |
|---|---|---|---|---|
| Sex (Age) | Male (77 years) | Male (57 years) | Female (62 years) | Male (78 years) |
| Pain location | V1 dermatome of the trigeminal nerve, mainly involving the eye, forehead, temple, and right side of the head | Right anterior thigh to right posterior waist, corresponding to L2 dermatome | Neck, right chest to right back, corresponding to C4–T4 dermatomes | Right chest to right back, corresponding to T2–T4 dermatomes |
| Duration of pain before therapy | 4 months | 5 months | 5 months | 6 months |
| Previous treatment | Oral analgesics and antivirals | Oral analgesics | Oral analgesics | Oral analgesics |
| Primary intervention | Supraorbital and infraorbital steroid injections | Lumbar interlaminar epidural steroid injection | Stellate ganglion steroid injection | Thoracic interlaminar epidural steroid injection |
| 5DW | Yes | Yes | Yes | Yes |
| Number of injection sites | 10 | 10 | 25 | 15 |
| Duration of intervention | 3 weeks | 4 weeks | 3 weeks | 3 weeks |
| Initial VAS | 8–9 | 7–8 | 8 | 8–9 |
| Second VAS | 4–5 | 2–3 | 5–6 | 4–5 |
| Third VAS | 1–2 | 0 | 4–5 | 2–3 |
| VAS – visual analogue scale; 5DW – 5% dextrose in water. | ||||