Trigeminal Herpes Zoster Transited to Ipsilateral Occipital Neuralgia

Round 1

Reviewer 1 Report

The case report refers to an occipital neuralgia secondary to a HZ infection prevalent on the third ipsilateral branch. The invitation to use an anesthetic block of the occipital nerve as a diagnostic element should be discussed more broadly.

Author Response

The case report refers to an occipital neuralgia secondary to a HZ infection prevalent on the third ipsilateral branch. The invitation to use an anesthetic block of the occipital nerve as a diagnostic element should be discussed more broadly.

Thank you for the comment

A local anesthetic block of the suspected nerve may aid the diagnostic process [10], but requires a thorough familiarity with the local anatomy.  Relief from an occipital nerve block is also not entirely specific for ON, and false-positive results occur with TMD, migraine, and cluster headaches.  According to a previous review article, the occipital nerve block may be a good treatment option for ON, although we did not do a diagnostic block on the patient. [11]

Author Response File: Author Response.pdf

Reviewer 2 Report

This case report demonstrated herpes zoster in the first branch of the trigeminal nerve followed by occipital neuralgia with herpes zoster in the second cervical nerve area on the ipsilateral side. The manuscript is well structured and well discussed. However, some points should be checked and corrected before its acceptance in this journal. 

• The study's background should be clearly stated. Describe the introduction and review of the work (Please add more information).
• The conclusion also adds some more information. Yes. This case report needs some more clarity.

Author Response

Comments and Suggestions for Authors

This case report demonstrated herpes zoster in the first branch of the trigeminal nerve followed by occipital neuralgia with herpes zoster in the second cervical nerve area on the ipsilateral side. The manuscript is well structured and well discussed. However, some points should be checked and corrected before its acceptance in this journal.

 

Thank you for the comment

 

 

The study's background should be clearly stated. Describe the introduction and review of the work (Please add more information).

We also created a neuroanatomical schematic for the trigeminal spinal nucleus caudalis and upper cervical spinal cord, and discussed the use of local anesthetic as a diagnostic aid.

 

The conclusion also adds some more information. Yes. This case report needs some more clarity.

A thorough understanding of the neuroanatomy would allow for anesthetic nerve blocking as a diagnostic aid, though great care should be taken when doing so, and the potential for a false positive should be considered.

 

 

Author Response File: Author Response.pdf