Post-Herpetic Neuralgia
Post-herpetic neuralgia (PHN) is a chronic neuropathic pain syndrome that occurs as a complication of herpes zoster (shingles), which is caused by the reactivation of the varicella-zoster virus (VZV). PHN is defined as pain that persists in a dermatomal distribution for at least 90 days after the onset of the herpes zoster rash.[1]
The pathophysiology of PHN involves nerve damage and inflammation caused by the reactivation of VZV, leading to persistent pain that can last for months to years.[2] Risk factors for developing PHN include older age, severe acute pain during the herpes zoster episode, and severe rash.[3]
The most important treatment in acute Herpes Zoster is antiviral therapy within 72 hours.[4] Management of PHN focuses on symptom control. First-line treatments include topical agents such as lidocaine and capsaicin, tricyclic antidepressants, and gabapentinoids.[1] For refractory cases, interventional techniques are potential options but are controversial and the evidence is poor (epidural injection and pulsed radiofrequency of the dorsal root ganglion).
Resources
References
- ↑ 1.0 1.1 Saguil, Aaron; Kane, Shawn; Mercado, Michael; Lauters, Rebecca (2017-11-15). "Herpes Zoster and Postherpetic Neuralgia: Prevention and Management". American Family Physician. 96 (10): 656–663. ISSN 1532-0650. PMID 29431387.
- ↑ Gónima Valero, Edmundo; Mendoza, Walter Antanas Sosa; Sarmiento, Diana A.; Amaya, Sebastian (2023-06). "Analgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review". Journal of Pain & Palliative Care Pharmacotherapy. 37 (2): 184–193. doi:10.1080/15360288.2023.2174632. ISSN 1536-0539. PMID 36731106. Check date values in:
|date=(help) - ↑ Gónima Valero, Edmundo; Mendoza, Walter Antanas Sosa; Sarmiento, Diana A.; Amaya, Sebastian (2023-06). "Analgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review". Journal of Pain & Palliative Care Pharmacotherapy. 37 (2): 184–193. doi:10.1080/15360288.2023.2174632. ISSN 1536-0539. PMID 36731106. Check date values in:
|date=(help) - ↑ Gónima Valero, Edmundo; Mendoza, Walter Antanas Sosa; Sarmiento, Diana A.; Amaya, Sebastian (2023-06). "Analgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review". Journal of Pain & Palliative Care Pharmacotherapy. 37 (2): 184–193. doi:10.1080/15360288.2023.2174632. ISSN 1536-0539. PMID 36731106. Check date values in:
|date=(help)
