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Anesth Analg 2007; 105:1127-1129
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000280536.96489.95
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GENERAL ARTICLES

A Unique Case of Recurrent Asystole Secondary to Paroxysmal Pain of Acute Herpetic Ophthalmicus

Man-Yiu Cheung, MBBS, and Melissa Viney, MBBS, FANZCA, FFPMANZCA

From the Geelong Hospital, Victoria, Australia.

Address correspondence and reprint requests to Man-Yiu Cheung, MBBS, 7 Ian St., Balwyn VIC 3103, Australia. Address e-mail to manyiucheung{at}yahoo.com.

Postherpetic neuralgia is considered to be the most common and debilitating complication of acute herpes zoster and its incidence and duration of symptoms increase with age. We describe an unusual, but life-threatening complication of postherpetic neuralgia. The following case report is the first to describe a patient who developed unexpected asystolic episodes as a result of complicating pain secondary to acute herpetic ophthalmicus. The underlying pathogenesis of her cardiovascular disturbance coinciding with her painful paroxysms is unclear. This uncommon phenomenon may be explained by an exaggerated vasovagal response or even by the oculocardiac reflex rarely observed outside ocular or maxillofacial surgery. Her severe paroxysmal pain and asystole were eventually managed with oxycontin, amitriptyline, gabapentin, and intranasal fentanyl spray.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.