Escolar Documentos
Profissional Documentos
Cultura Documentos
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by Dr. Yvette Colon on 09/27/11
For personal use only.
Postherpetic Neuralgia
Naileshni Singh
A B STRA CT
Questions from patients about analgesic pharmacotherapy and responses from authors are presented to help
educate patients and make them more effective self-advocates. The topic addressed in this issue is postherpetic
neuralgia, symptoms, risk factors, and treatment.
KEYWORDS acyclovir, capsaicin, corticosteroids, herpes zoster, lidocaine, neuropathic analgesics, postherpetic neuralgia, shingles, varicella-zoster
Answer
Postherpetic neuralgia (PHN) can be an unfortunate
result of herpes zoster infection (shingles). The residual pain following the acute infection is termed postherpetic neuralgia and often presents as one-sided
neuropathic (nerve) pain affecting thoracic areas of
the body (chest, back) (1). The acute phase of the
disease should be treated immediately with antiviral
agents. The prolonged painful state of PHN can be
treated with steroids, neuropathic analgesics, topical
drugs, opioids, and a variety of other treatments (2).
Millions of adults throughout the world annually are affected by the acute herpes zoster infecNaileshni S. Singh, MD, is a Pain Management Fellow, Department of
Anesthesiology, Division of Pain Medicine, University of California Davis
Medical Center, Sacramento, California, USA.
Address correspondence to: Dr. Naileshni S. Singh, Division of Pain Medicine,
UC Davis Medical Center, Lawrence J. Ellison Ambulatory Care Center, 4860 Y Street, Suite 3020, Sacramento, CA 95817, USA (E-mail:
naileshni.singh@ucdmc.ucdavis.edu).
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by Dr. Yvette Colon on 09/27/11
For personal use only.
188
N. Singh
J Pain Palliat Care Pharmacother Downloaded from informahealthcare.com by Dr. Yvette Colon on 09/27/11
For personal use only.
C
189
REFERENCES
[1] Opstelten W, McElhaney J, Weinberger B, Oaklander AL, Johnson RW. The impact of varicella zoster virus: chronic pain. J Clin
Virol. 2010;48:S1, S8S13.
[2] Whitley RJ, Volpi A, McKendrick M, van Wijck A, Oaklander AL.
Management of herpes zoster and post-herpetic neuralgia now
and in the future. J Clin Virol. 2010;48:S1, S20S28.
[3] Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis,
pathophysiological mechanisms, and treatment. Lancet Neurol.
2010;9:807819.
[4] Centers for Disease Control and Prevention. Prevention of
herpes zoster: recommendations of the advisory committee on immunization practices. MMWR Morb Mort Wkly
Rep. 2008:57;130. Available at: http://www.cdc.gov/mmwr/
preview/mmwrhtml/rr5705a1.htm. Accessed December 14,
2010.
[5] Hornberger, J, Robertus K. Cost-effectiveness of a vaccine to prevent herpes zoster and post herpetic neuralgia in older adults. Ann
Intern Med. 2006;145:317325.
[6] Dworkin R, OConnor AB, Bakonja M, et al. Pharmacologic
management of neuropathic pain: evidence-based recommendations. Pain. 2007;132:237251.