1: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Nov;41(11):821-4. [Bilateral facial nerve paralysis-diagnosis and treatment] [Article in Chinese] Wang H, Gao ZQ, Li YL, Liu W, Quan SM. Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. OBJECTIVE: To observe the ways of diagnosis and treatment of bilateral facial nerve palsy. METHODS: Seven cases of bilateral facial nerve paralysis in 1996 - 2003 were retrospectively reviewed, and then the ways of diagnosis and therapies of these cases were analyzed. There were 6 patients with doubtless diagnosis. They were diagnosed as acute leukaemia, Vogt-Koyanagi-Harada disease (VKH), Machado-Jesoph disease, bilateral mandible fractures, Guillain-Barre syndrome, and Bell's palsy. The last one was diagnosed as Herpes zoster virus infection or Lyme disease. In all these cases, there were 4 of 5 positive cerebrospinal fluids test, 1 of 6 positive lyme antibody test, 2 of 5 positive images test, 7 of 7 EMG and Br test showed that the paralysis was peripheral palsy. All the 7 cases were treated with steroid and vitamin. RESULTS: House-Brackmann I was defined as complete recovery, after up to 2 months follow up, there were four cases got completely recovery while 2 cases incomplete recovery, and 1 case was not reacted to the therapy. CONCLUSIONS: Bilateral facial nerve paralysis was rare, and it was difficult to diagnosis and differentiation, while diagnostic mistakes would be serious. More attention should be paid to it in clinic. Publication Types: English Abstract PMID: 17283534 [PubMed - in process] 2: Otolaryngol Head Neck Surg. 2007 Feb;136(2):313-4. Hutchinson sign and herpes zoster. Murrell GL, Hayes BH. Naval Hospital Camp Pendleton California, Camp Pendleton, CA; Uniformed Services University of the Health Sciences, Bethesda, MD, and George Washington University School of Health Sciences, Washington, DC. PMID: 17275563 [PubMed - in process] 3: Arch Phys Med Rehabil. 2007 Feb;88(2):255-8. Postherpetic neuralgia involving the right c5 dermatome treated with a cervical transforaminal epidural steroid injection: a case report. Shakir A, Kimbrough DA, Mehta B. Western Reserve Spine and Pain Institute, Kent, OH. Shakir A, Kimbrough DA, Mehta B. Postherpetic neuralgia involving the right C5 dermatome treated with a cervical transforaminal epidural steroid injection: a case report. A 66-year-old woman presented with 2 weeks of debilitating right upper-limb pain with a vesicular rash over the right C5 dermatome secondary to herpes zoster. Her pain failed to improve with: oral narcotics, divalproex, gabapentin, pregabalin, and topical 2% lidocaine cream. Six weeks postonset, a right C5 transforaminal epidural steroid injection (TESI) under fluoroscopic guidance was performed. Prior to the injection, her numeric pain intensity was rated as 9 to 10/10, and 15 minutes after the injection, it was reduced to 3/10. At 2 weeks, her pain had maintained an intensity of 3/10 and over another 2 weeks had resolved. She remained pain-free 3 months later. In this case, the use of a cervical TESI provided dramatic results in the treatment of debilitating postherpetic neuralgia (PHN). Further investigation is needed to determine the efficacy of TESI in the early management of PHN. PMID: 17270526 [PubMed - in process] 4: Rev Med Interne. 2007 Jan 17; [Epub ahead of print] [Immunization of adults against varicella and herpes zoster.] [Article in French] Hanslik T, Blanchon T, Alvarez FP. Service de medecine interne, hopital Ambroise-Pare, universite Versailles-Saint-Quentin-en-Yvelines, Assistance publique-Hopitaux de Paris, 9, avenue Charles-de-Gaulle, 92104 Boulogne Billancourt cedex, France; Inserm, U707, universite Pierre-et-Marie-Curie, UMR S 707, 75012 Paris, France. PURPOSE: Following the commercialisation in France of the varicella vaccine and the European marketing authorization for a vaccine against zoster, this article intends to review the epidemiology of varicella and herpes zoster, to expose the characteristics of the available vaccines, and to consider the advantages and caveats of the different immunisation strategies. CURRENT KNOWLEDGE AND KEY POINTS: In France, from 550.000 to 750.000 cases of varicella are reported each year, which result in more than 3.500 hospitalizations and about 20 deaths. Subjects>/=15 years old represent 8.3% of the total number of cases of varicella, 26% of varicella-related hospitalisations and 69% of all varicella-related deaths. The susceptibility rate for the 15 years old is 10,3 and 79% of these non-immune subjects are expected to contract varicella. The vaccines currently marketed against varicella are safe, have a good immunogenicity and remain effective over the evaluated periods. Two vaccination strategies are considered: a generalized vaccination of the infants and children, or a vaccination targeted against high-risk populations and non-immune teenagers and adults. The incidence of herpes zoster is estimated in France at 235.000 new cases per year, from which 1% is hospitalized. A live attenuated vaccine using the same strain as the varicella vaccine, but at a much higher dose, proved its efficacy in terms of reducing shingles and postherpetic neuralgia incidences, of 51 and 67% respectively. This vaccine received a marketing authorisation in France, for adults>/=60 years old. FUTURE PROSPECTS: Uncertainties about the impact of vaccination on varicella and herpes zoster epidemiology have yet to be solved, such as the potential increase in herpes zoster incidence or in the absolute number of diagnosed varicella cases in older age groups, or the loss of vaccination-induced immunity with time. These questions demonstrate the need for an operational real-time surveillance network to monitor varicella and herpes zoster incidence in the setting of general population immunisation. PMID: 17270316 [PubMed - as supplied by publisher] 5: Georgian Med News. 2006 Dec;(141):50-3. Peculiarities of herpes zoster in immunocompetent and immunocompromised hosts. Sharvadze L, Tsertsvadze T, Gochitashvili N, Bolokadze N, Dolmazashvili E. Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia. The aim of five years (2000-2005) study was to investigate the peculiarities of Herpes Zoster in immunocompromised and immunocompetent patients. For this purpose we have investigated the clinical course of Herpes Zoster, disease duration, complications of disease, as in acute phase as well as postherpetic neuralgia in 74 HIV positive (1st group) and 74 HIV negative (2nd group) groups of patients. In both group of patients we have studied the prevalence of the following complications: 1. Acute complications of Herpes Zoster: a) Neurological: motor neuropathy, cranial neuritis, meningoencephalitis, transverse myelitis. b) Ophthalmic: keratitis, iritis, retinitis, visual impairment c) Cutaneous: bacterial superinfection, scarring, disfigurement. d) Visceral: pneumonitis, hepatitis. e) Multidermatomal. 2. The complications of after resolution of infection: a) Postherpetic neuralgia and various duration of pain associated with postherpetic neuralgia such as : < month, 1-6 months, 6-12 months and >1 year durations. b) Recurrent herpes zoster. Herpes Zoster infection was diagnosed based on clinical symptoms and by detection of VZV specific IgM and IgG by ELISA. HIV infection was diagnosed by ELISA method and was confirmed by Western Blot. We found that Herpes Zoster may develop as in HIV positive as well as HIV negative population. Study showed that severe cases of disease (Herpes Zoster), long duration and rate of complications are much higher in HIV/AIDS than in HIV negative group patients. Rate of hospitalization is also higher in HIV/AIDS patients with Herpes Zoster than in HIV negative patients with Herpes Zoster. Frequency of recurrent Herpes Zoster is much higher in HIV/AIDS patients than in HIV negative patients. The postherpetic neuralgia is very frequent complication for both group (HIV positive and HIV negative) Herpes Zoster patients, but its duration longer in HIV/AIDS patients in comparison HIV negative group. There were no significant difference in disease severity, duration and complications among male and female patients. PMID: 17261887 [PubMed - in process] 6: Neurology. 2007 Jan 30;68(5):E4. Spinal myoclonus following herpes zoster radiculitis. Estraneo A, Saltalamacchia AM, Loreto V. Salvatore Maugeri Foundation, IRCCS Via Bagni Vecchi, 82037 Telese Terme (BN), Italy. aestraneo@fsm.it PMID: 17261675 [PubMed - in process] 7: Manag Care. 2006 Dec;15(12):57-8. Herpes zoster vaccine brings relief for the elderly. Morrow T. Genentech Inc. PMID: 17260848 [PubMed - in process] 8: Rinsho Shinkeigaku. 2006 Sep;46(9):664-7. [A case of herpes zoster associated Guillain-Barre syndrome with a relapse of eruptions after intravenous immunoglobulin therapy] [Article in Japanese] Nagane Y, Utsugisawa K, Obara D. Department of Neurology, Hanamaki General Hospital. A 77-year-old woman developed progressive dysesthesia, hypesthesia and weakness in four extremities immediately after improvement of herpes zoster in the left Th10 dermatome area. Examination of the cerebrospinal fluid (CSF) showed an increase in protein concentrations. Evidence of demyelinating polyneuropathy was demonstrated by nerve conduction studies. Her hypesthesia and weakness in the extremities were gradually improved following intravenous immunoglobulin therapy (IVIg). Varicella zoster virus (VZV) titer levels in CSF well correlated both with neurological symptoms and CSF protein concentrations. VZV DNA in the CSF was not detectable. These findings suggested autoimmune Guillain-Barre syndrome (GBS) associated with herpes zoster. An interesting finding in the present patient is that one day after the completion of IVIg, when the neurological symptoms in the extremities were apparently ameliorating, the herpes zoster eruptions again emerged in the left L3 dermatome area. By treatment with intravenous acyclovir, the vesicular eruptions were improved. We assume that IVIg might suppress the immune response against VZV and promote the recurrence of eruptions. Publication Types: English Abstract PMID: 17260813 [PubMed - in process] 9: Pharmacoeconomics. 2007;25(2):155-69. Acute/Subacute Herpes Zoster: Healthcare Resource Utilisation and Costs in a Group of US Health Plans. Insinga RP, Itzler RF, Pellissier JM. Department of Health Economic Statistics, Merck Research Laboratories, North Wales, Pennsylvania, USA. BACKGROUND: Although there are estimated to be nearly 1 million cases of herpes zoster diagnosed in the US each year, the economic costs associated with herpes zoster in the US have not been well described. OBJECTIVE: To describe the healthcare resource utilisation and costs associated with physician-diagnosed acute/subacute herpes zoster, from a payer perspective, using a large US healthcare claims database. METHODS: Data for the period 2000-1 were obtained from the Medstat Marketscan healthcare claims database. The duration of acute/subacute herpes zoster was considered to include the 21 days preceding, and 90 days following, the initial herpes zoster diagnosis. Resource utilisation was examined for individuals with newly diagnosed acute/subacute herpes zoster (n = 8741) and compared, through regression analyses, with that observed for control individuals from the same population (n = 50 000). Similar analyses were conducted for costs; the costs included reflected healthcare payments from patients, insurers and other sources.Regression analyses controlled for demographics (age, gender), conditions that have been observed with greater frequency among patients with acute/subacute herpes zoster in prior studies (cancer, HIV infection, organ transplantation, other immunosuppressive conditions and therapies) and the number of billed services within each of seven categories of care that were potentially related to acute/subacute herpes zoster and that were utilised within the 30-180 days prior to the diagnosis for affected patients, and over an analogous period for controls. RESULTS: The acute/subacute phase of herpes zoster was estimated to result in an average of 1.7 (standard error [SE] 0.02) additional physician and hospital outpatient visits, 0.05 (SE 0.003) additional emergency room visits, 0.03 (SE 0.003) additional inpatient hospital admissions, 2.1 (SE 0.03) additional prescriptions filled and $US431 (SE 17.60) in additional healthcare costs per patient. Among patients with acute/subacute herpes zoster, 21.1% had a diagnosis code with a designation for a herpes zoster-related complication, and 9.4% had three or more outpatient visits with a diagnosis code for herpes zoster. The average estimated incremental costs per patient with acute/subacute disease increased with age, ranging from $US258 (SE 37.70) among patients aged /=80 years. The numbers of additional outpatient visits, inpatient admissions, prescriptions filled for pain medications and coded complications were also substantially higher among older than younger patients with acute/subacute herpes zoster. CONCLUSIONS: The management of acute/subacute herpes zoster was found to result in substantial healthcare costs, with outpatient care and prescription drugs comprising the majority of the cost burden. To more fully understand the overall cost of herpes zoster disease to society, future studies should examine the healthcare costs associated with post-herpetic neuralgia and productivity losses due to herpes zoster and post-herpetic neuralgia. PMID: 17249857 [PubMed - in process] 10: Singapore Med J. 2007 Jan;48(1):e16-8. Herpes zoster complicating imatinib mesylate for gastrointestinal stromal tumour. Durosinmi MA, Ogbe PO, Salawu L, Oyekunle AA. Departments of Haematology and Blood Transfusion, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. mdurosin@yahoo.com Varicella zoster virus (VZV) infection is uncommon in patients with gastrointestinal stromal tumour (GIST) and who have not been exposed to extensive radiotherapy and/or high-dose chemotherapy. We report a 56-year-old Nigerian man with GIST who developed VZV infection while on imatinib mesylate therapy. From August 2003 to November 2005, 64 patients (GIST/CML = 6/58) were enrolled into an ongoing Glivec (imatinib mesylate) international patient-assistance programme therapy for Philadelphia/bcr-abl-positive chronic myeloid leukaemia (CML) and CD117-positive GIST patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The patient developed herpes zoster (HZ) infection 23 months into therapy with Glivec. With his absolute lymphocyte count at 2,774 cells per microlitre and CD4 count at 950 cells per microlitre, no obvious immunological defect was observed. Prompt resolution of symptoms without sequelae was achieved by treating with acyclovir, analgesic and dressing of lesions with desiccant. To our knowledge, this is the first reported case of HZ infection in a patient with GIST on Glivec therapy, and the response is similar to that of CML patients who developed VZV while on similar therapy. PMID: 17245498 [PubMed - in process] 11: Pain Med. 2007 Jan-Feb;8(1):36-40. Effectiveness of prostaglandin e1 for the treatment of patients with neuropathic pain following herpes zoster. Kanai A, Osawa S, Suzuki A, Ishimaru R, Hoka S. Department of Anesthesiology, Kitasato University School of Medicine, Japan. Objective. Postherpetic neuralgia (PHN) is one of the most painful neuropathic conditions, the mechanism of which remains unclear. There is no universally accepted treatment. The pain in PHN is often relieved by bathing, heating, or sympathetic blockade, suggesting a circulation-dependent property of the pain. Therefore, we examined the effectiveness of prostaglandin E(1) (PGE(1)), which has an analgesic effect via improvement of peripheral blood circulation, for patients with PHN. Design. A total of 27 patients with PHN underwent intravenous administration of 60 microg of PGE(1) dissolved in 100 mL of physiological saline and 5 mL of 8.4% sodium bicarbonate solution at an infusion rate of 0.02 microg/kg/min. Oral administration of PGE(1), limaprost alfadex, was followed at doses of 30 microg/day for 2 weeks. Pain at rest and tactile allodynia before and after the treatment was evaluated with visual analog scale (VAS). Results. Intravenous PGE(1) significantly decreased VAS in rest pain and tactile allodynia without severe adverse effects. The analgesic effect of PGE(1) continued during the 2 weeks of oral administration of PGE(1). Oral PGE(1) caused nausea in seven cases, diarrhea in three, and abdominal distention in one subject. All subjects, except for two cases of nausea, continued the treatment until the end of the study, although some required a decrease in the dose to 15 microg/day. During the 2-week oral administration, the VAS did not change remarkably in the three patients whose VAS were not decreased by at least 80% during the initial infusion. Conclusions. The results of the present study indicate that oral PGE(1) following the intravenous administration produces prompt and continuous analgesia in patients with PHN. Moreover, the intravenous treatment using PGE(1) appears useful for predicting the analgesic effect of PGE(1) in the patients. PMID: 17244102 [PubMed - in process] 12: Cutis. 2006 Dec;78(6):418-22. Scar sarcoidosis: a case report and brief review. Selim A, Ehrsam E, Atassi MB, Khachemoune A. Endocrine Unit, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA. Scar sarcoidosis refers to lesions of cutaneous sarcoidosis that appear in preexisting scars. This condition may be caused by mechanical trauma such as skin cuts or venipuncture, scars caused by infection such as herpes zoster, and tattoos. We present a case of a 34-year-old man who developed scar sarcoidosis following minor trauma to the left calf. We review the epidemiology, clinical presentations, pathophysiology, and treatment options for scar sarcoidosis. PMID: 17243430 [PubMed - in process] 13: J Cutan Med Surg. 2006 May-Jun;10(3):139-41. Cutaneous lupus erythematosus limited to the site of a laceration. Timani S, Mutasim DF. Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0592, USA. BACKGROUND: Cutaneous lupus erythematosus is known to occur at sites of trauma or inflammation of the skin, including sites of tattoo, frostbite, herpes zoster scar, burn scar, and implantation by windshield glass. OBJECTIVE: We report a 32-year-old white man who developed cutaneous lupus erythematosus at the site of a laceration. The diagnosis was confirmed by histologic and immunofluorescence examination. The patient responded to intralesional corticosteroid and hydroxychloroquine therapy. CONCLUSION: Lupus erythematosus may be induced by trauma. PMID: 17241591 [PubMed - in process] 14: J Travel Med. 2007 Jan-Feb;14(1):65-6. Herpes zoster after yellow Fever vaccination. Bayas JM, Gonzalez-Alvarez R, Guinovart C. Preventive Medicine Service, International Vaccination Centre, Hospital Clinic-IDIBAPS, Barcelona, Spain. An immunocompetent 64-year-old women presented with brachial herpes zoster (HZ) infection 3 days after vaccination against yellow fever (YF). The lesions disappeared after antiviral treatment. There are very few reports of a possible association between YF vaccination and HZ infection. This case supports the importance of continuing surveillance of vaccine adverse events. PMID: 17241257 [PubMed - in process] 15: Drugs Aging. 2007;24(1):1-19. Post-herpetic neuralgia in older adults : evidence-based approaches to clinical management. Christo PJ, Hobelmann G, Maine DN. Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Many individuals across the globe have been exposed to the varicella-zoster virus (VZV) that causes chickenpox. After chickenpox has resolved, the virus remains latent in the dorsal root ganglia where it can re-emerge later in life as herpes zoster, otherwise known as shingles. Herpes zoster is a transient disease characterised by a dermatomal rash that is usually associated with significant pain. Post-herpetic neuralgia (PHN) is the term used for the condition that exists if the pain persists after the rash has resolved. Advanced age and compromised cell-mediated immunity are significant risk factors for reactivation of herpes zoster and the subsequent development of PHN. Though the pathophysiology of PHN is unclear, studies suggest peripheral and central demyelination as well as neuronal destruction are involved.Both the vaccine against VZV (Varivax((R))) and the newly released vaccine against herpes zoster (Zostavax((R))) may lead to substantial reductions in morbidity from herpes zoster and PHN. In addition, current evidence suggests that multiple medications are effective in reducing the pain associated with PHN. These include tricyclic antidepressants, antiepileptics, opioids, NMDA receptor antagonists as well as topical lidocaine (lignocaine) and capsaicin. Reasonable evidence supports the use of intrathecal corticosteroids, but the potential for neurological sequelae should prompt caution with their application. Epidural corticosteroids have not been shown to provide effective analgesia for PHN. Sympathetic blockade may assist in treating the pain of herpes zoster or PHN. For intractable PHN pain, practitioners have performed delicate surgeries and attempted novel therapies. Although such therapies may help reduce pain, they have been associated with disappointing results, with up to 50% of patients failing to receive acceptable pain relief. Hence, it is likely that the most effective future treatment for this disease will focus on prevention of VZV infection and immunisation against herpes zoster infection with a novel vaccine. PMID: 17233544 [PubMed - in process] 16: J Infect Dis. 2007 Feb 15;195(4):502-10. Epub 2007 Jan 10. DNA sequence variability in isolates recovered from patients with postvaccination rash or herpes zoster caused by oka varicella vaccine. Loparev VN, Rubtcova E, Seward JF, Levin MJ, Schmid DS. National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA. SSchmid@cdc.gov. Little is known about the pathogenic potential of individual strains in the varicella vaccine. We analyzed genomic variation among specimens obtained from vaccine recipients with postvaccination rash or herpes zoster (HZ), focusing on polymorphisms between live attenuated varicella vaccine virus and wild-type varicella-zoster virus. Eleven of 18 postvaccination HZ specimens contained >1 strain, and 7 of 18 appeared to be clonal. All 21 postvaccination rash specimens contained mixtures of vaccine strains. Four single-nucleotide polymorphisms (SNPs) consistently occurred in every isolate; all were polymorphisms in open-reading frame (ORF) 62, and 2 confer amino acid substitutions in the immediate-early protein 62. Four wild-type SNPs occurred in every isolate: one each occurred in ORF 10, ORF 21, ORF 62, and a noncoding region upstream of ORF 64. The frequencies of the remaining wild-type SNPs were variable, with the SNPs uniformly expressed (even in mixtures) in 20.5%-97.4% of isolates (mean frequency, 67.7%). No 2 clinical isolates had identical SNP profiles; as such, vaccine latency usually involves >1 strain. PMID: 17230409 [PubMed - in process] 17: Health News. 2006 Nov;12(11):12. I've had one bout with shingles. Can I get it again? Can I prevent it? [No authors listed] PMID: 17228401 [PubMed - indexed for MEDLINE] 18: Vaccine. 2007 Feb 26;25(10):1877-83. Epub 2006 Oct 30. Safety and tolerability of a high-potency zoster vaccine in adults >/=50 years of age. Tyring SK, Diaz-Mitoma F, Padget LG, Nunez M, Poland G, Cassidy WM, Bundick ND, Li J, Chan IS, Stek JE, Annunziato PW; The Protocol 009 Study Group. University of Texas Health Science Center, Houston, TX, United States. BACKGROUND: Herpes zoster (HZ) incidence rises with age, especially after 50 years of age, probably due to waning varicella-zoster virus (VZV)-specific immunity. The Shingles Prevention Study [Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults, N Engl J Med 2005;352:2271-84], enrolled people >/=60 years of age and showed that zoster vaccine prevents HZ and postherpetic neuralgia (PHN), presumably through boosting VZV-specific immunity. This study of people >/=50 years of age compared the safety and tolerability of two zoster vaccine potencies. METHODS: Adults >/=50 years old enrolled in a randomized, double-blind, multicenter study to compare the safety and tolerability of one dose of two zoster vaccine potencies, approximately 58,000 and approximately 207,000 plaque-forming units/dose. Adverse experiences (AEs) were recorded on a standardized Vaccination Report Card for 42 days postvaccination. For assessment of injection-site AEs, clinically acceptable tolerability was predefined based on experience with PNEUMOVAXtrade mark 23, a licensed vaccine recommended for use in older people. RESULTS: Six hundred and ninety-eight subjects (age 50-90 years, median 64 years) were enrolled. No serious vaccine-related AEs were reported. Similar AE rates were observed in the higher and lower potency groups (overall systemic AEs: 37.5 and 39.3%, vaccine-related systemic AEs: 10.9 and 13.2%, injection-site AEs: 63.0 and 59.8%). Rates for a combined endpoint of moderate or severe injection-site pain/tenderness/soreness and swelling were 17.2% (95% CI 13.9, 21.0) and 9.0% (95% CI 5.6, 13.4), respectively. Most combined endpoint events were reported as moderate in intensity. CONCLUSIONS: Both vaccine potencies were generally well tolerated in this study of people >/=50 years of age. Although rates of some moderate or severe injection-site AEs were greater in the higher potency group, all rates met the prespecified criteria for clinically acceptable tolerability. PMID: 17227688 [PubMed - in process] 19: J Headache Pain. 2007 Jan 15; [Epub ahead of print] The rare, unilateral headaches. Vaga study of headache epidemiology. Sjaastad O, Bakketeig LS. Department of Neurology, St. Olavs Hospital, Trondheim University Hospitals (NTNU), N-7006, Trondheim, Norway. In the Vaga study of headache epidemiology, 1838 parishioners in the age group 18-65 years were included (88.6% of the relevant population). Each individual was questioned in a face-to-face situation. In this population, a search of rare unilateral headaches was also made, in spite of their presumed rarity. Trigeminal neuralgia was present in two cases. Two individuals with SUNCT traits were observed. Hemicrania continua may have been present in one individual. Also observed were: optic neuritis (n=1), herpes zoster (n=4); a case of unilateral headache upon neck rotation (chronic paroxysmal hemicrania variant? or "forme fruste" of the neck-tongue syndrome?); masseter muscle spasm (n=1); temporo-mandibular joint dislocation (n=1); and possible carotidynia (n=3). A particularly intriguing form of headache was a unilateral, neuralgiform (?) pain, associated with ipsilateral, regular jabs and allodynia, a combination observed in eight females. A couple of conditions that entirely defy rubrication are also reported. PMID: 17221345 [PubMed - as supplied by publisher] 20: Am J Med Sci. 2007 Jan;333(1):56-7. Herpes zoster ophthalmicus and syndrome of inappropriate antidiuretic hormone secretion. Dhawan SS. From the Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee. Presented here is a case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) that developed in an elderly woman with single dermatomal herpes varicella zoster ophthalmicus without evidence of varicella-zoster encephalitis or dissemination. This is only the third such case reported in the English language literature to date, and it affirms that SIADH can develop in patients with herpetic involvement of just a single dermatome and corrects with resolution of the herpetic lesions. PMID: 17220695 [PubMed - in process]