BACKGROUND: Post-herpetic Neuralgia (PHN) is the most common complication of Herpes Zoster (HZ) and is characteristically difficult to treat with limited pharmacologic and interventional options. We present a case of PHN of the supraorbital branch of the trigeminal nerve successfully treated with thermal radiofrequency ablation.

CASE REPORT: An 82 year-old woman with a 7 year history of supraorbital branch neuralgia following HZ, presented to clinic with pain refractory to a multimodal oral pain regimen. Her pain resolved for 3 days after a supraorbital nerve block, and she had durable relief following right supraorbital thermal radiofrequency nerve ablation (RFA) which produced a > 75% decrease in her pain and lasting for months. She currently continues to receive this treatment every 6 to 10 months.

CONCLUSION: When medications fail, RFA is a potential treatment option for V1. Additionally, the risk of post-RFA neuritis and anesthesia dolorosa should be considered.

KEYWORDS: Herpes zoster, post-herpetic neuralgia, radiofrequency ablation, supraorbital nerve, trigeminal neuralgia