Postherpetic Neuralgia

Postherpetic Neuralgia General Information

The generic medical term of Postherpetic Neuralgia defines a type of neuralgia that occurs due to an infection with the varicella zoster virus. In most cases, the affection is painful and affects the skin and nerve fibers in a specific dermatomic area which had been previously affected by a herpes zoster outbreak. Typically, the neuralgia begins once the herpes zoster vesicles have developed a crust and the healing process has started. In some cases however, the affection can occur without being preceded by a herpes zoster outbreak, and in such situations it is presumed that the neuralgia is secondary to a zoster sine herpete type of outbreak.
 
The varicella zoster virus is the cause of the childhood disease known under the name of chickenpox. After the affection heals, the virus may remain within the organism in a dormant state, in the nerve cells. In such cases, it is possible that the virus reactivates after longer or shorter periods of time – sometimes years later – causing the herpes zoster outbreak, also commonly known as shingles. In such cases the reactivated virus will travel through the nervous tracts, causing pain, and once it reaches the skin it produces an eruption of blisters and rash. The herpes zoster condition generally heals within one month from the outbreak; however some patients continue to experience pain for prolonged periods of time after the condition has healed – which is the Postherpetic Neuralgia condition. This can be treated through a variety of therapies and treatments; however complete relief of the pain is not always obtained.

Postherpetic Neuralgia Symptoms

In cases of Postherpetic Neuralgia, patients will normally only present symptoms in the area of the skin that was initially affected by the herpes zoster outbreak. The symptoms that the patient may experience can vary from one case to another, as each organism has a different way of reacting to certain stimuli, and in some situations it is possible for a patient to present symptoms that are unique to their case. However, in typical situations, the patient will experience severe pain under the form of burning or aching; it may occur in attacks of sharp pain, or it may be chronic and may be manifested as a deep aching in the affected area. Also, the pain will also appear and / or grow in intensity if the patient is touched in that particular dermatomic area, or if temperature changes occur.

Itching and numbness have also been reported in cases of Postherpetic Neuralgia, especially in cases where the affected area is larger. Headaches may accompany the condition and severe cases where the affected nerves are the ones controlling the regional muscles, the patient may also present a pronounced weakness of the muscles or paralysis. As stated before, these are not the only symptoms that may appear in cases of Postherpetic Neuralgia. If you experience any unexpected and / or unpleasant effects, or if you have reason to suspect that you are being affected by this condition, it is highly advised that you consult a specialized health care professional as they will be able to consult you and provide you with more information.

Postherpetic Neuralgia Treatment

At this time, there is no single cure for Postherpetic Neuralgia, and the treatment method that will be applied in your case will largely depend on the type of pain that you are experiencing, as well as on personal information such as age, general health condition, medical history and allergies. There are several possible therapies, involving antidepressants, anticonvulsants, steroids, painkillers or other means of pain relief.

Antidepressants may be prescribed in cases of Postherpetic Neuralgia as they affect certain brain chemicals that, among other functions, have an effect on the way the body interprets pain. Such substances as serotonin and norepinephrine are affected by such drugs, and although they do not completely relieve the pain, they may reduce its intensity making it more bearable. Examples of such drugs from the antidepressants class are Duloxetine, Desipramine, Amitriptyline and Nortriptyline. In some cases, the examining health care professional may prescribe a Postherpetic Neuralgia treatment based on certain anticonvulsant drugs, as they may also serve to reduce the pain caused by this affection. Pregabalin, Gabapentin or other anticonvulsants may prove effective in such situations, as they serve by stabilizing the electrical activity of injured nerves.

Corticosteroid class drugs may also be administered to the patient through an injection in the region near the spinal cord; however this type of treatment is not applicable until the herpes zoster skin rash has completely receded. Another type of drugs that may be prescribed to relieve pain in patients affected by Postherpetic Neuralgia is the painkiller class. Such medication as Tramadol or Oxycodone-based medication can be prescribed in these cases but the prescribing health care specialist should be careful to eliminate any possibility of side effects and addiction. Among other types of therapy that may be employed to control pain, transcutaneous electrical nerve stimulation (TENS), peripheral or spinal cord nerve stimulation and Lidocaine skin patches have also been employed, with varying results.

TENS has been used with some success in a number of cases, while other patients have not experienced any positive results from this therapy. It consists of placing a few electrodes over the affected area of the skin, and these electrodes will generate small painless impulses of electricity into the regional nervous pathways. Spinal cord stimulation, along with peripheral nerve stimulation are therapies similar to TENS, however in this case the devices are implanted under the patient’s skin through surgery. Before implanting the devices, a test is performed to ensure that the patient will experience proper pain relief upon activating the devices. This therapy method may not be used in some cases, for example when the affected areas are on regions of the patient’s face, chest or abdomen.

Lidocaine skin patches are bandage-like patches imbibed with Lidocaine, a topical medicine that is used for general pain relief. Temporary relief is obtained by applying the patches to the affected area. This therapy may not prove to be suitable in cases where the affected areas are on the patient’s face. Treatment may bring complete pain relief in some cases of Postherpetic Neuralgia. However, in most cases the pain is only dampened by the treatment, while some patients do not feel any relief at all. The condition may pass within a few months from occurring, but there have been cases where the disease affected the patients for the rest of their lives.