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What Is Postherpetic Neuralgia?
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Postherpetic neuralgia is the acute pain caused after the herpes zoster attack. It basically attacks the nervous system causing peripheral nerve damage. It causes a pathologic damage from the skin to the spinal cord, it can be defined as the dermatomal pain till 90 days even after the occurrence of herpes zoster rash. During clinical trials, the pain measured for postherpetic neuralgia can range from 0 to 100 on a Likert scale.
The duration of pain for postherpetic neuralgia is variable and almost 50% of people recover till one year.
In the affected region, you find a patchy allodynia, hyperesthesia, hypoesthesia, ophthalmic involvement risk and diabetes which can even result in depression, social isolation and increased healthcare utilization.
The patients that are immunocompromised are at increased risk of neurological complications and VZV reactivation.
Postherpetic Neuralgia clinical points:
• It results in increased suffering and decreased quality of life.
• The frequencies of being infected with herpes zoster and postherpetic neuralgia increase with age.
• Treatment involves systematic and topical therapies with tricyclic, gabapentin and pregabalin antidepressants.
• Opioid analgesics can be used, but there is an increased risk and uncertainty of long-term benefits.
• The herpes zoster vaccination can reduce both the risks of herpes zoster as well as postherpetic neuralgia.
Mostly postherpetic neuralgia is a diagnostic challenge as the history of herpes zoster is difficult to confirm with certainty. Pain associated with PHN can be divided into three categories:
• The spontaneous ongoing pain with burning sensation
• Electric shock or paroxysmal shooting pain
• And evoked sensations that are amplifications of light touch resulting in pathological changes of noxious stimuli to innocuous stimuli
There is topical or systematic treatment depending on the duration and changes that occur while carrying out the treatment. You can trust best pain management doctors in india for the treatment of postherpetic neuralgia treatment.
It is the first line of treatment for postherpetic neuralgia, used in combination with systematic drugs when the pain is severe or moderate. Patches with 5% lidocaine available are approved in USA and Europe, however the efficacy is limited. There are placebo-controlled trials carried out too. But the lindociane treatments work better as compared to placebo-controlled treatment. The Capsaicin 0.075% is highly effective in the postherpetic neuralgia.
The systematic treatment supports tricyclic antidepressants and antiepileptic drugs gabapentin and pregabalin are used. The metanalysis of tricyclic antidepressants in placebo-controlled trials is done with mitriptyline, desipramine, or nortriptyline. Oxocodone and opioids including tramadol are considered as third-line drugs and used with appropriate goals and close monitoring. You should also take into consideration the trigeminal neuralgia pain treatment and prevention along with herpes zoster treatment.
Acetaminophen and nonsteroidal anti-inflammatory drugs are ineffective for the treatment.
The treatment for postherpetic neuralgia and herpes zoster varies in people depending on how much the infection is and also the line of treatment being applied to the patient. Thus postherpetic neuralgia prevention is important.
For the past 3 years I have been writing informative and high quality articles on pain. In the above article have covered topics the trigeminal neuralgia pain treatment and best pain management doctors in india.
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