Postherpetic Neuralgia is a complication related to herpes zoster, otherwise known as shingles. Shingles is an infectious disease that is characterized by intense and often debilitating pain. In most patients, the rash and blisters disappear within just a few weeks, but when the pain lasts even after the visible signs are gone, the condition becomes postherpetic neuralgia.
The burning pain of postherpetic neuralgia is due to the fact that it affects the nerve fibers of the skin and that is why it is often severe enough to interfere with appetite and sleep. As one ages, the risk of having an episode of postherpetic neuralgia increases; as a result, people over 60 are more often victims. Even the area of the body where it appears makes a difference in whether someone will eventually experience this painful condition. Those who have shingles on the face are far more likely to have it than when it appears elsewhere.
Causes
Chickenpox is a common childhood disease that once it has cleared up, the person affected has built up immunity to. However, the virus responsible for chickenpox remains in the body. As a person ages, for some reason that may be related to stress, the virus can reactivate at the site it has been harbored for years into what is known as shingles. Due to the immunity, there is no rash all over the body, but instead it is localized to the area it has infected. When the nerve fibers of this infected area suffer damage, postherpetic neuralgia can present itself.
Symptoms
Symptoms are normally limited to the area of the body affected by the first breakout which is usually in a band around the trunk of the body and often on just one side. Those symptoms typically show up as burning, deep, aching, often sharp and stabbing pain. Patients are often so sensitive to even the lightest touch that they can hardly bear the touch of the clothing they are wearing. This is often called alladynia. Some people with postherpetic neuralgia experience an itchy feeling and numbness. In the rarest of cases, when the nerves involved are associated with the control of muscles, weakness or paralysis can occur.
Treatment
Famciclover is the medication that is typically chosen to treat herpes zoster at its onset. It is thought that this treatment will reduce the incidence of additional problems that can arise with postherpetic neuralgia.
It is often quite difficult to determine the best treatment options for those suffering from this painful condition. However, for some patients, NSAIDs offer some relief, but in other cases, it is necessary to use stouter medications that are based on narcotics. Tricyclic antidepressants such as fluphenazine and amitriptyline are recommended to reduce the severity of the condition. It is vital that patients be monitored to make sure that drug dependence does not occur. Lidocaine skin patches are also prescribed in some cases because they offer from 4 to 12 hours of relief for the pain. Corticosteroids are also sometimes given as a measure intended to prevent occurrence of postherpetic neuralgia in other areas. Zostavax, a product made by Merck has been shown to be very effective in treating shingles and preventing Postherpetic Neuralgia.