Post-zoster neuralgia

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Classification according to ICD-10
G53.0 * Neuralgia after herpes zoster
B02.2 + Herpes zoster involving other parts of the nervous system
ICD-10 online (WHO version 2019)

A post-herpetic neuralgia (PZN) - even post-herpetic neuralgia or postherpetic neuralgia called - reflected in such. Sometimes extremely severe nerve pain as a result of shingles . It mainly affects the elderly. Nerves were probably damaged by the varicella zoster virus .

Manifestations

The pain can come in different forms:

  • as permanent burning or boring pain
  • as short, violent attacks of pain
  • than severe pain to touch

causes

A PZN is caused by the varicella zoster virus (VZV). This virus belongs to the herpes virus family . After a chickenpox infection has healed, the viruses remain in the body and can become active again years later. You can then z. B. trigger a so-called shingles when the immune system is weakened. In this disease, also known as herpes zoster or zoster, fluid-filled vesicles form in a band-shaped section of skin on the side of the body. The disease usually heals after a few weeks. In about every 10th patient, however, permanent nerve damage remains, which can develop into a PZN.

treatment

Those affected suffer z. Sometimes enormous under the severe pain. The condition cannot yet be cured, as the nerve pain cannot be reversed. However, pain relievers such as Tramadol (Tramal) can be given for the pain . Also, antidepressants or anticonvulsants such as pregabalin (Lyrica) and gabapentin (Neurontin) are used in low doses because they can inhibit pain transmission to the brain. Further treatment methods are topical anesthetic ointments or plasters, capsaicin creams or electrical stimulation of skin nerves; further help may also be expected from a medical pain therapist. Psychotherapy can also be helpful to make it easier for patients to cope with their pain.

course

The disease is more common in older people than in young people and is also more severe. On average, every second patient over 60 with shingles suffers from PZN, otherwise it is only around 10%. The earlier the disease is treated, the higher the chances of success and the lower the risk of permanent damage.

literature

  • Reinhard Marre u. a .: Clinical Infectious Diseases . 2. actual Urban & Fischer, Munich 2008, ISBN 978-3-437-21741-8 .
  • Cedric A. Mims et al. a .: Medical microbiology - infectious diseases . Urban & Fischer, Munich 2006, ISBN 3-437-41272-8 .

Individual evidence

  1. ↑ Shrestha M, Chen A: Modalities in managing postherpetic neuralgia. , Korean J Pain. 2018 Oct; 31 (4): 235-243, Review, PMID 30310548
  2. ^ Swedish Council on Health Technology Assessment: Methods of Treating Chronic Pain: A Systematic Review [Internet] . Stockholm: Swedish Council on Health Technology Assessment (SBU); 2006 Oct, PMID 28876750
  3. ^ Hadley GR, Gayle JA, Ripoll J, Jones MR, Argoff CE, Kaye RJ, Kaye AD: Post-herpetic Neuralgia: a Review. , Curr Pain Headache Rep. 2016 Mar; 20 (3): 17, Review. Erratum in: Curr Pain Headache Rep. 2016 Apr; 20 (4): 28. PMID 26879875
  4. ↑ Gossrau G: Postherpetic neuralgia. , Neurologist. 2015 Feb; 86 (2): 219-28, German, PMID 25659844

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