Post herpetic neuralgia and the dermatologist

Sugeng, Maria Widijanti; Yosipovitch, Gil; Leok, Goh Chee

doi:10.1046/j.1365-4362.2001.00079.x

Cited by 8 publications

(7 citation statements)

References 56 publications

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“…The evidence was low quality due to the high risk of the studies, the small number of studies included in each meta-analysis (n=2) and the inconsistency of the results (unexplained heterogeneity with high I2 > 70%), heterogeneity of the interventions, comparison interventions (placebo, acyclovir or carbamazepine) and the outcomes (incidence and severity of PHN; incidence, duration and severity of pain), all which made it impossible to compare many studies in one meta-analysis. Reviews published on the topic of corticosteroid efficacy in the prevention of PHN [20][21][22][23][24][25][26][27][28][29][30] agreed with our systematic review results; corticosteroids do not prevent PHN. Also, some reviews [30] were not able to interpret the effect of corticosteroids on PHN due to the poor quality of the evidence.…”

Section: Discussionsupporting

confidence: 81%

Oral Corticosteroid Therapy for Preventing Postherpetic Neuralgia: A Systematic Review and Meta-analysis

Heatrice¹,

Alavi²,

Han³

et al. 2017

ojdom

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The purpose of this systematic review was to examine the efficacy of oral corticosteroids for prevention of postherpetic neuralgia (PHN). Randomized controlled trials of patients suffering from herpes zoster comparing corticosteroids to control therapy (placebo or carbamazepine) or acyclovir were included. Three electronic databases (MEDLINE via PubMed, Web of Science and The Cochrane Library) were searched. Two authors assessed all eligible studies for risk of bias. Ninety-one references were found. After applying inclusion/exclusion criteria 7 studies were eligible for this systematic review. All 7 studies were at high risk of bias. Corticosteroids, rather than carbamazepine, protected the patients against PHN (Relative Risk [RR] = 0.543, 95% CI 0.087 to 3.376, p=0.512), however the results were not statistically significant. Additionally, a second meta-analysis showed that the use of corticosteroids does not prevent PHN compared to the use of a placebo (RR=0.990, 95% CI 0.092 to 10.663, p=0.994). Mild and reversible side effects were reported in patients taking only corticosteroids; two serious cardiovascular events were reported in the patients prescribed acyclovir and corticosteroid, though those two events were probably unrelated to the therapy. Individual studies reported quality of life improvements and reduction in the incidence and severity of pain with the addition of prednisone to acyclovir therapy; however the heterogeneity of the outcomes and comparison group prevented from performing meta-analyses on these outcomes. Due to the low number of studies, high risk of bias, heterogeneity of the outcomes and comparison groups, the evidence this systematic review provided was of low quality.

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Section: Discussionsupporting

confidence: 81%

Oral Corticosteroid Therapy for Preventing Postherpetic Neuralgia: A Systematic Review and Meta-analysis

Heatrice¹,

Alavi²,

Han³

et al. 2017

ojdom

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“…Allodynia may be related to the formation of new connections involving central pain transmission neurons. 4,5 Treatment-refractory PHN is a common phenomenon in daily clinical practice. 2 However, the precise mechanism of allodynia remains obscure.…”

mentioning

confidence: 99%

Botulinum Toxin A in Postherpetic Neuralgia

Apalla

Sotiriou

Lallas

et al. 2013

The Clinical Journal of Pain

107

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“…Os relatos de caso encontrados na literatura 11,22,23 utilizam como parâmetro de avaliação da dor a visual analog scale (VAS), que consiste em uma escala visual na qual o paciente deve assinalar a intensidade da dor sentida nas últimas 24 horas, com zero correspondendo à ausência de dor e dez à dor máxima sentida.…”

Section: Uso Da Toxina Botulínica Na Neuralgia Pós-herpéticaunclassified

“…As técnicas de aplicação variaram quanto à disposição na área afetada, ora sendo aplicadas em linhas quadriculadas, 3,4,11,20 ora dispostas em leque. 24 Na maioria dos estudos, BTX-A foi administrada por via subcutânea ou intradérmica com doses fracionadas variando de 2,5 a 7,5 UI/ cm 2 na área dolorosa, não sendo ultrapassadas 200 UI no total.…”

Section: Técnica De Aplicaçãounclassified

Toxina botulínica: uma nova opção para o tratamento da neuralgia pós-herpética?

Talarico

2014

Revista Hospital Universitário Pedro Ernesto

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ResumoA dor neuropática pode ocorrer após injúria do sistema nervoso central ou periférico, gerando dor espontânea, alodínea e hiperalgesia. Uma das principais causas de dor neuropática é a neuralgia pós-herpética. Sua incidência aumenta em pacientes com idade mais avançada, o que dificulta ainda mais o tratamento, muitas vezes limitado por seus efeitos colaterais, principalmente cognitivos. A combinação de tratamentos é prática clínica comum e novas modalidades terapêuticas vêm sendo aplicadas para aliviar essa condição. A toxina botulínica tipo A tem sido usada para diversos quadros clínicos associados à hiperatividade muscular, como distonia cervical. Recentemente, foram propostos mecanismos analgésicos independentes da contração muscular, ainda pouco conhecidos.Descritores: Neuralgia; Neuralgia pós-herpética; Toxinas botulínicas tipo A. AbstractNeuropathic pain can occur after injury to the peripheral and/or central nervous system, resulting in spontaneous pain, allodynia and hyperalgesia. One of the main causes of neuropathic pain is post-herpetic neuralgia. It occurs increasingly with age and that makes the treatment even more complicated due to the limitation caused by cognitive adverse effects. Combining therapies with different mechanisms of action is usual in clinical practice and new procedures are considered to treat this condition. Botulinum toxin type A has been used to treat certain disorders related to muscle overactivity. Not well known analgesic mechanisms have been proposed recently, independent of the muscle contraction.Keywords: Neuralgia; Neuralgia, postherpetic; Botulinum toxins, type A. ResumenEl dolor neuropático puede darse después del daño al sistema nervioso central o periférico, provocando dolor espontáneo alodinia y hiperalgesia. Una de las principales causas del dolor neuropático es la neuralgia postherpética. Su incidencia aumenta en pacientes de edad avanzada, lo que dificulta todavía más el tratamiento, muchas veces limitado por sus efectos colaterales, principalmente cognitivos. La combinación de tratamientos es práctica clínica común y se vienen aplicando nuevas modalidades terapeúticas para aliviar esta situación. La toxina botulínica tipo A ha sido usada en diversos cuadros clínicos asociados a la hiperactividad muscular, como distonía cervical. Recientemente, fueron propuestos mecanismos analgésicos independientes de la contracción muscular, todavía poco conocidos.Palabras clave: Neuralgia; Neuralgia posherpética; Toxinas botulínicas tipo A.* Endereço para correspondência: Rua Maestro Francisco Braga, 175, ap. 101 Rio de Janeiro, RJ, Brasil. CEP: 22041-070.

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Post herpetic neuralgia and the dermatologist

Cited by 8 publications

References 56 publications

Oral Corticosteroid Therapy for Preventing Postherpetic Neuralgia: A Systematic Review and Meta-analysis

Oral Corticosteroid Therapy for Preventing Postherpetic Neuralgia: A Systematic Review and Meta-analysis

Botulinum Toxin A in Postherpetic Neuralgia

Toxina botulínica: uma nova opção para o tratamento da neuralgia pós-herpética?

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