Response of intractable post herpetic neuralgia to intrathecal baclofen.

An intractable case of Post-herpetic Neuralgia (PHN) in which all other treatment options were exhausted was successfully treated with intrathecal baclofen infusion with a complex continuous delivery mode. A 72-year old man presented to the pain clinic with a 4-year history of left lower extremity PHN. He had seen multiple experts in the field, failed numerous pharmacological therapies, and interventional techniques. After multiple neuraxial medications were tried, baclofen was chosen and an intrathecal drug delivery system was implanted. Eight months after the procedure he continues to have 80 % pain relief. PHN is a devastating complication of shingles. Fortunately, most cases respond to conventional therapies. For intractable cases intrathecal baclofen appears to be a safe and effective therapeutic modality.