What is postherpetic neuralgia?
Postherpetic neuralgia (PHN) is a painful, chronic condition that is more likely to develop in older patients following an attack of shingles (varicella-zoster virus). Even after the acute rash of shingles subsides, pain can persist in shingles-affected areas. With PHN, the pain persists for longer than four month after the onset of the rash. PHN occurs most often in elderly people and in patients whose immune systems have been compromised.
What causes PHN?
The pain of PHN, which occurs in the same area as the pain and rash of shingles, results from damage to nerve fibers during the shingles infection. Shingles is caused by a re-activation of the varicella-zoster virus (VZV), the same virus that causes chickenpox. Anyone who has had chickenpox can get shingles, but the disorder is most common in people over the age of 50.
How is PHN diagnosed?
PHN usually is diagnosed when a patient’s pain lasts four months or more after acute attack of shingles, or when pain persists more than 90 days or appears after the skin lesions of shingles have healed.
What are the symptoms of PHN?
In PHN, pain is intense and might be described as burning, stabbing, or gnawing. Affected areas of the body might be hypersensitive or might have decreased sensation. Areas previously affected by shingles might show evidence of cutaneous (related to the skin) scarring.
How is PHN treated?
Patients with PHN should receive treatment to control acute symptoms and prevent complications. PHN is treated with medicines, including tricyclic topical analgesic agents, anticonvulsants, antidepressants, and opioid analgesics. In some cases, there is a natural tendency for PHN to improve over time without treatment, but that improvement usually levels off after one year from the onset of symptoms.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/1/2004
