Study Of Dermatomes Somatosensory Evoked Potentials In Patients With Herpes Zoster-related Neuralgia

Objective: To study the injury of intercostal nerve Aβ fibers in patients with herpes zoster-related neuralgia by means of dermatomes somatosensory evoked potential(DSEP).To explore the abnormal rate of DSEP of intercostal nerve in patients with herpes zoster(HZ)neuralgia and post herpetic neuralgia(PHN),and to explore the relationship between Aβ fiber injury and pain days,pain degree and other factors.Methods: From January 2018 to December 2019,22 patients with herpes zosterrelated neuralgia at the First Affiliated Hospital of Dalian Medical University were collected.At the same time,the general data(gender,age),the days of pain,the days of skin lesions of patients were collected.According to the clinical diagnosis,the patients were divided into two groups: herpes zoster neuralgia group and postherpetic neuralgia group.According to visual analogue scale(VAS),the patients were divided into mild pain group(0-3),moderate pain group(4-6)and severe pain group(7-10).According to the score of neuropathic pain screening scale(ID pain),the patients were divided into two groups: ID pain < 4 group and ID pain ≥ 4 group;According to the form of sensory disturbance,it can be divided into following groups: non acupuncture sense group,acupuncture sense group,non burning sense group,burning sense group,non numbness sense group,numbness sense group,non electric shock sense group,electric shock sense group,non tactile induced pain group,tactile induced pain group The bilateral dermatomes somatosensory evoked potentials(DSEP)results in patients with herpes zoster associated neuralgia were analyzed by comparing the affected side with the healthy side.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),and SF-36 score were recorded.SPSS 22.0 statistical application software was used for statistical analysis of all data.Results:1.The abnormal rate of DSEP in 22 patients with herpes zoster-related neuralgia was 100%.The abnormal rate of DSEP latency was 40.91%,the abnormal rate of DSEP amplitude was 90.91%,and the abnormal rate of DSEP waveform was 13.64% in all patients.2.There was no statistical difference in DSEP latency abnormality rate between the groups of HZ neuralgia group and PHN group,ID Pain<4 group and ID Pain≥4 group,mild pain group and moderate pain group and severe pain group,no acupuncture feeling and acupuncture feeling,no burning and burning,no numbness and numbness,no touch inductance and touch inductance,non-tactile-induced pain and tactile-induced pain,nonheat-induced pain and heat-induced pain.3.The difference of N1 and P1 latency in patients with acupuncture feeling was significantly different from these in patients without acupuncture feeling.There was no statistical difference in latency of N1,P1,N2,and P2 between the groups of no burning and burning,no numbness and numbness,no touch inductance and touch inductance,nontactile-induced pain and tactile-induced pain,non-heat-induced pain and heat-induced pain.4.There was a moderately negative correlation between P1 latency of herpes zoster-related neuralgia and days of pain.There was a moderately positive correlation between P2 latency of herpes zoster-related neuralgia and the duration of skin lesions.The difference of N1,P1,N2,P2 latency between the sick and healthy side of herpes zosterrelated neuralgia patients was not related to the ID Pain,VAS score and age.5.There is no correlation between the degree of pain and HAMA score and HAMD score.There was a negative correlation between the degree of pain and SF-36 score.Conclusion:1.There was Aβ fiber injury in intercostal nerve in patients with herpes zosterrelated neuralgia patients.2.There was no difference in the abnormality rate of DSEP latency between HZ and PHN patients.There was no difference in Aβ fiber damage between HZ and PHN patients.3.The injury of intercostal nerve Aβ fiber was more obvious in patients with acupuncture sense than in patients without acupuncture sense.4.There was no correlation between Aβ fiber damage and pain severity.Aβ fiber damage was inversely related to the duration of pain.A β fiber damage was positively related to the duration of skin damage.