# Efficacy of Intravenous Lidocaine and Magnesium in the Management of Herpes Zoster Neuritis and Postherpetic Neuralgia: A Case Series

## TL;DR

This study shows that intravenous lidocaine and magnesium can reduce pain in patients with herpes zoster-related nerve pain when immediate therapy is not possible.

## Contribution

The study provides evidence for using intravenous lidocaine and magnesium as an alternative treatment for herpes zoster neuritis and postherpetic neuralgia.

## Key findings

- Pain scores significantly decreased after the first week of treatment.
- Pain scores continued to decrease over the four-week treatment period.
- More treatments were associated with greater pain reduction.

## Abstract

Objectives: Herpes zoster is a common disease encountered in clinical practice. The neuropathic pain caused by herpes zoster can be severe enough to interfere with daily life in challenging cases. Although it is said that intervening as early as possible after the onset of the disease improves outcomes, there are some cases that are difficult to treat as immediate interventional therapy is not possible. While there are some reports on the efficacy of intravenous magnesium and lidocaine, we investigated the efficacy of intravenous magnesium and lidocaine in patients with herpes zoster neuritis and postherpetic neuralgia.

Patient criteria: A total of 23 patients with herpes zoster neuritis and postherpetic neuralgia were included in the study. We included only cases in which immediate interventional therapy was not possible.

Methods: The treatment protocol was an intravenous infusion of a combination of 1.2 g of magnesium and 100 mg of lidocaine for one hour every week for four weeks (five times in total). Patients were assessed using the Numerical Rating Scale (NRS) for pain before and after the treatment at week zero and before the treatment at weeks one, two, three, and four.

Results: There was a statistically significant difference between the median NRS before treatment at week zero and the median NRS before treatment at week one. Similarly, there was a statistically significant difference between the median NRS before treatment at week zero and the median NRS before treatment at weeks two, three, and four. In addition, the NRS tended to decrease as the number of treatments increased.

Conclusions: Intravenous lidocaine and magnesium may be effective for herpes zoster neuritis and postherpetic neuralgia. It may be a treatment method for when immediate interventional therapy is not possible.