Prognostic Factors of Postherpetic Neuralgia

Abstract

The investigation was aimed to determine prognostic factors related to postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation. The age (≥50 yr), surface area involved (≥9%), and duration of severe pain (≥4 weeks) might be the main factors that lead to PHN. On the other hand, gender, dermatomal distribution, accompanied systemic conditions, and interval between initial pain and initiation of treatment might not be implicated in PHN. The subjects were orally received antiviral (valacyclovir), tricyclic antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard treatment in the group 1. In addition to the standard medication, lidocaine solution was sub-and/or perilesionally injected in the group 2, while lidocaine plus prilocaine cream was topically applied to the skin lesions in the group 3. The rates of PHN in the 3 treatment groups were not significantly different, suggesting adjuvant anesthetics may not be helpful to reduce the severity of pain.

The effects of repetitive transcranial magnetic stimulation on the whole-brain functional network of postherpetic neuralgia patients

“…It is characterized as a sharp, burning or stabbing pain which is usually associated with irreparable damage to the peripheral nervous system. [1–3] It can affect the quality of life of patients because of loss of productivity and the associated cost of treatment. [4] Currently, the general clinical treatment is pharmacological intervention which might lead to considerable risk of side effects especially from long-term drug use.…”

Intravenous Vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study

“…Although there are several serious complications of zoster (ophthalmic, splanchnic, cerebral, motor complications), the most common and most feared one in immunocompetent adults is postherpetic neuralgia (PHN). Reported incidences of PHN range between 18% and 33% depending on patient age and assessment time after the infection [1–6]. A recent study reported that 24% of the patients studied had postherpetic neuralgia pain for more than 90 days after rash onset.…”

Risk factors for postherpetic neuralgia in patients with herpes zoster

“…2,11 Studies by independent groups of investigators have now established that greater acute pain severity, 12,13 greater rash severity, 14,15 and the presence of a painful prodrome preceding the rash 16,17 are additional risk factors for PHN. 2,11 Studies by independent groups of investigators have now established that greater acute pain severity, 12,13 greater rash severity, 14,15 and the presence of a painful prodrome preceding the rash 16,17 are additional risk factors for PHN.…”