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A single‐center randomized controlled trial was performed to examine the effectiveness of local methylcobalamin injection for the management of subacute ophthalmic herpetic neuralgia (SOHN).
The ophthalmic division of the trigeminal nerve is one of
the most commonly involved sites of postherpetic neuralgia (PHN). In this
study, a significant difference in the overall changes for the mean pain scores
was noted among 3 treatment approaches (local injection, intramuscular and oral)
of local neurotrophic drugs describing local methylcobalamin therapy to be the
most effective for pain relief (in 91% patients) in SOHN.
A single‐center randomized controlled trial
was performed to examine the effectiveness of local methylcobalamin injection
for the management of subacute ophthalmic herpetic neuralgia (SOHN).
All in all, 105 patients with a pain score of 4 or greater
were randomized to be given methylcobalamin combined with lidocaine using local
injection (LM, 35 patients), intramuscular methylcobalamin and local lidocaine
injection (IM, 35 patients), and oral methylcobalamin tablet and lidocaine
local injection (OM, 35 patients) for 4 weeks. The treatment responses were
assesed via multilevel mixed modeling.
A significant reduction in pain scores was observed in
patients who received local methylcobalamin (6.7 at baseline versus 2.8 at
endpoint) than with systemic administration (IM 6.8 versus 4.9 and oral 6.7
versus 5.1). Clinically significant pain reduction of pain (more than 30%) was observed
in 91% of patients in the local methylcobalamin group, a significantly greater
proportion as compared to the systemic groups (66% IM and 57% oral). The use of
analgesic decreased notably in the local group (94% at baseline versus 6% at
endpoint) except systemic groups (IM 97% versus 86%, oral 94% versus 80%). Local
group had an improved health‐related quality of life as
compared to systemic groups. Higher age was related with a poorer response to
methylcobalamin in mixed modeling.
Local injection of methylcobalamin provides significant
pain relief from SOHN and is better than systemic administration.
PAIN Practice
Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial
Gang Xu et al.
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