Post Herpetic Neuralgia

Post herpetic neuralgia is pain in the area where a shingles infection once occurred. The pain may last for months or years.

Causes

Post herpetic neuralgia occurs when the nerves have been damaged after an outbreak of shingles. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox.

Post herpetic neuralgia is more likely to occur in people over age 60.

Symptoms

The main symptom is pain in the area where shingles once occurred. The pain can range from mild to very severe. It lasts for months, sometimes years, after the original shingles infection.

Treatment

Anticonvulsant drugs, usually used for seizures, may help with the pain of damaged nerves. Gabapentin and pregabalin are the ones most commonly used to treat post herpetic neuralgia.

Skin patches with lidocaine (a numbing medicine) may also be prescribed to relieve some of the pain for a period of time.

Pain medications are often needed. Sometimes acetaminophen or NSAIDs such as ibuprofen are enough. Many patients will need stronger, prescription drugs such as codeine, hydrocodone, oxycodone.

Drugs used to treat depression (antidepressants) may also help reduce pain, as well as help with sleep.

Electrical nerve stimulators may be used for severe, long-term cases of post herpetic neuralgia.

Consultation with a pain specialist may be necessary in some cases.

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