Post Herpetic Neuralgia (PHN)

Last updated 20.09.12

 

Index

 

Features

- Pain in dermatomal distribution > 3 months after Herpes Zoster infection

-  10-15% pts w Herpes Zoster (Shingles)

-  Severe prodrom increased likelihood for PHN

-  Highest risk is from trigeminal nerve or brachial plexus

-  Increased incidence in elderly

-  At 60 years old 60% pts w Zoster get PHN

-  At 70 years old 75% pts w Zoster get PHN

 

Associated S/S

-  Pain

-  Neuropathic: burning, stabbing, gnawing

-  At 1 month 10% pts still have pain

-  3 months 5%, 1 year 3%

-  Allodynia (non-noxious pain)

-  Effected area may show hypo or hyperesthesia, cutaneous scarring or hypopigmentation

 

Dx

-  Hx of Herpes Zoster (Shingles)

 

Mx

-  Notifiable disease in Australia

-  Analgesia

-  TCAs: Amitryptyline

-  Anticonvulsants: Gabapentin, Pregabalin

-  Local Anaesthetics: Lidocaine

-  Capsaicin cream

-  Corticosteroids