Trigeminal Herpes Zoster: Early Recognition and Treatment –A Case Report

Efficacy of topical Interferon Alfa- 2b used as an adjunct in the management of primary OSSN

“…Post-herpetic neuralgia can be managed with the use of anticonvulsants such as gabapentin, phenytoin, carbamazepine, and tricyclic antidepressants. 4,5 In the present case, management was done using antiviral drug along with anti-convulsant carbamazepine with a dose of 100mg per day and gabapentin (300mg per day). Later, when the patient developed signs and symptoms of facial palsy, corticosteroid was administered.…”

“…The early diagnosis and initiation of management is indicated in herpes zoster infection to alleviate symptoms and to prevent secondary infection. Management includes anti-virals which includes the acyclovir (800mg), [2][3][4] valacyclovir (1000mg) 1 and famcyclovir (500mg). 5 But because of poor bioavailability, 6 valacyclovir (1000mg three times a day) and famcyclovir (500mg three times a day) is the drug of choice for oral administration.…”

Trigeminal Herpes Zoster: A Brief Review

“…This latency can be found in ganglia like geniculate, vestibular, trigeminal, cervical, thoracic, and sacral ganglia. Trigeminal ganglia are most commonly affected in the head and neck regions until the VZV gets reactivated and causes HZ years after the initial infection (in the older age group) once the immunity has waned or there are other predisposing factors including physical trauma, increased age, stress, radiation therapy, and immunocompromised states like HIV infection (3,9).…”

“…It occurs at all ages with an incidence of 5 -10 cases per 1,000 persons aged above 60 years of age (7). The lesion typically is limited to one or two dermatomes with thoracic dermatome (50 -60%), cervical dermatome (10 -20% and trigeminal dermatome), being frequently involved with lumbar and sacral dermatomes, showing the least involvement, presented as unilateral rashes on the face and trunk, and sometimes involving extremities that further develop crustations and resolve in about two weeks (3,11).…”

“…It has a bioavailability of 15 -30% and a half-life of three hours. When given within 72 hours of rash, it decreases pain and promotes healing, but the intensity of postherpetic neuralgia is not reduced (3,22). The drug is well tolerated orally, but some cases of headache, nausea, malaise, and CNS effects have been reported, whereas rashes, sweating, hypotension, and emesis when given intravenously (21).…”