Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2023; 11(9): 2015-2020
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2015
Motor cortex transcranial magnetic stimulation to reduce intractable postherpetic neuralgia with poor response to other threapies: Report of two cases
Huan Wang, Yu-Zhong Hu, Xian-Wei Che, Liang Yu
Huan Wang, Yu-Zhong Hu, Liang Yu, Department of Anesthesiology, Zhejiang Chinese Medicine University, Hangzhou 310000, Zhejiang Province, China
Xian-Wei Che, Transcranial Magnetic Stimulation Centre, Deqing Hospital of Hangzhou Normal University, Hangzhou 310000, Zhejiang Province, China
Liang Yu, Department of Pain, Hangzhou First People's Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Wang H contributed to literature search, and manuscript drafting and writing; Che XW contributed to supervision and writing of the manuscript; Hu YZ and Yu L contributed to literature search; all authors made substantial contributions to conception and design and data acquisition, analysis, or interpretation; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Liang Yu, MD, Chief Physician, Department of Anesthesiology, Zhejiang Chinese Medicine University, No. 548 Binwen Road, Hangzhou 310000, Zhejiang Province, China.
Received: November 14, 2022
Peer-review started: November 15, 2022
First decision: December 26, 2022
Revised: January 5, 2023
Accepted: February 21, 2023
Article in press: February 21, 2023
Published online: March 26, 2023

Postherpetic neuralgia (PHN) is a typical neuropathic pain condition that appears in the lesioned skin regions following the healing of shingles. The pain condition tends to persist, which is often accompanied by negative emotions (e.g., anxiety and depression) and substantially reduces the quality of life. In addition to analgesia (e.g., pregabalin and gabapentin), nerve radiofrequency technology is an effective treatment for intractable PHN. However, there is still a significant portion of patients who do not benefit from this treatment. As a non-invasive form of brain stimulation, repetitive transcranial magnetic stimulation (rTMS) targeting the motor cortex is able to reduce neuropathic pain with grade A evidence.


Here we report two cases in which motor cortex rTMS was used to treat intractable PHN that did not respond to initial drug and radiofrequency therapies. Moreover, we specifically investigated rTMS efficacy at 3 mo following treatment.


Motor cortex rTMS can treat intractable PHN that did not respond to initial drug and radiofrequency therapies.

Keywords: Post herpetic neuralgia, Repetitive transcranial magnetic stimulation, Radiofrequency, Case report

Core Tip: Postherpetic neuralgia (PHN) is a kind of refractory neuropathic pain, which seriously affects the quality of life. Repetitive transcranial magnetic stimulation can be used as an effective complement to the treatment of patients with refractory PHN.