Post Herpetic Neuralgia Related To Neuropathic Disorders

Today's short post from painhq.org (see link below) looks at postherpetic neuralgia which is a neurological extension of shingles. It's strange, almost everyone has heard of shingles and rightfully fears it for the pain it can bring but few associate it with neuropathy, yet in fact, it's one of the many forms of nerve damage that can fall under the general term of neuropathy. Shingles is a neuropathy caused by the reawakening of the varicella zoster virus, the same virus that causes chickenpox. In that respect it can be related to other forms of neuropathy brought about by viruses, such as HIV. This article sticks to the point and gives you a decent springboard for further research if you're suffering from either shingles or the misery of postherpetic neuralgia.
 

Postherpetic Neuralgia 
Info from Mayo Clinic and Wikipedia: Author unknown: 2014

What is Postherpetic Neuralgia? Postherpetic neuralgia is ​a complication of shingles. A case of shingles will typically only last a few weeks. If pain remains after the blisters and skin irritations subside, postherpetic neuralgia may be diagnosed. Early treatment of shingles can reduce the risk of developing postherpetic neuralgia.

Nerve fibres in the skin can be damaged during an outbreak of shingles, and the virus may remain resident in the nerve cell. When this happens, the nerves in the skin cannot communicate properly with the brain, resulting in postherpetic neuralgia.

What are the symptoms? Symptoms for postherpetic neuralgia present in the distribution of the nerve affected by the shingles. Individuals may experience a burning, sharp pain and a sensitivity to light touch (which may even include the touch of clothing against the skin). Less commonly, patients may experience a numb or itchy feeling in the affected areas, and in some cases, muscle weakness or paralysis.

Is there any treatment? Often a combination of different treatments are used to manage postherpetic neuralgia and any associated pain. Treatments include the use of topical medicines applied to the skin itself, such as lidocaine and capsaicin skin patches; as well as medicines taken by mouth such as anticonvulsants, antidepressants and opioid painkillers.

What treatment have you found most effective for Postherpetic Neuralgia?

Opioids (0)
Physical Therapy and Rehabilitation (0)
Gabapentin (1)
Pregabalin (1)
Topical Lidocaine (1)
Duloxetine (0)

What is the prognosis? Most individuals suffering from postherpetic neuralgia will experience a slow improvement of pain symptoms with treatment.

Related evidence 
Markley HG, Dunteman ED, Sweeney M. Real-World Experience with Once-Daily Gabapentin for the Treatment of Postherpetic Neuralgia (PHN). Clin J Pain. 2014 Jul 28. [Epub ahead of print]

Schlereth T, Heiland A, Breimhorst M, Féchir M, Kern U, Magerl W, Birklein F. Association between pain, central sensitization and anxiety in postherpetic neuralgia. Eur J Pain. 2014 Jul 28. doi: 10.1002/ejp.537. [Epub ahead of print]

References  
Mayo Clinic [Internet]. Postherpetic neuralgia [updated 2014; cited 2014 Aug 5]. Available from: http://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/basics/definition/con-20023743

Wikipedia [Internet]. Postherpetic neuralgia [updated 2014 Aug 16; cited 2014 Aug 5]. Available from: http://en.wikipedia.org/wiki/Postherpetic_neuralgia
 
https://www.painhq.org/learning/knowledge-base/category/conditions/peripheral-neuropathic-pain/post-herpetic-neuralgia