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We report a case of postherpetic neuralgia that was dramatically responsive to the antiepileptic drug gabapentin (neurontin). This agent may prove a safe and effective alternative to current therapy, such as carbamazepine or amytriptilline. Our case highlights the severe morbidity that can otherwise result from postherpetic neuralgia and its treatment, particularly in the elderly.
Case report.
A 77-year-old right-handed woman with rheumatic heart disease, on warfarin for atrial fibrillation and prosthetic mechanical aortic and mitral valves, presented in August 1994 with a left occipital hemorrhagic stroke. Three months before admission, she developed herpetic zoster in the right T4 dermatome that was complicated by severe burning postherpetic neuralgia. Ten days before admission, she became oversedated on oral narcotic analgesics and fell backward out of a chair, suffering bilateral rim occipital subdural hematomas. Because of the hemorrhage, her warfarin dose was decreased.
On August 7, the patient presented …
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