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Postherpetic Neuralgia (cont.)

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How long does postherpetic neuralgia last?

Only approximately 9%-15% of patients who get shingles develop PHN. For those few patients who develop PHN, the length of time that PHN lasts is variable; the majority of PHN patients may have PHN last one to two months. About one-third of PHN patients have symptoms that last about three months, and about one-fifth last a year or longer.

What are the complications of postherpetic neuralgia?

PHN itself is a complication of shingles. Other complications of PHN include lifestyle changes where the patient may become addicted to pain medications, have an inability to have a normal lifestyle (unable to exercise) because of constant pain, and have sleep and activities limited or even prohibited by touching or even have clothing touch the affected area. Patients taking opioids may become very constipated. In a few cases of PHN, muscle weakness can be an additional complication.

What is the prognosis for postherpetic neuralgia?

For the majority of patients who develop PHN, the prognosis is good although they may have to take pain medications for about one to three months. For others, the prognosis is fair to poor if the pain is severe, lasts longer than three months, and in a few patients markedly reduces their quality of life or results in permanent nerve damage; however, the disease is not fatal.

Can postherpetic neuralgia be prevented?

If shingles can be prevented, then PHN is also usually prevented. Fortunately, the vaccine Zostavax is about 70% effective in preventing shingles. The CDC recommends that everyone older than 60 years of age get the vaccine; in 2011, the FDA approved the vaccine for people aged 50 and above. The CDC states, "Zostavax should not be given to pregnant women, persons with a primary or acquired immunodeficiency, or to persons with a history of anaphylactic reaction to gelatin, neomycin, or any other component of the vaccine. Herpes zoster vaccine can be administered simultaneously with other indicated vaccines."

REFERENCES:

Levine, Norman, ed. "Understanding Postherpetic Neuralgia -- Treatment." WebMD.com. Apr. 7, 2012. <http://www.webmd.com/skin-problems-and-treatments/shingles/understanding-postherpetic-neuralgia-treatment>.

McElveen, W. Alvin. "Postherpetic Neuralgia." Medscape.com. July 3, 2012. <http://emedicine.medscape.com/article/1143066-overview>.

Stone, Jennifer A.M., Gettelfinger, Gary L., and Johnstone, Peter A.S. "Treatment of 13 Patients With Post-Herpetic Neuralgia Using Acupuncture." Journal of the Society for Integrative Oncology 8.4 Fall 2010: 125-130.

United States. Centers for Disease Control and Prevention. "Update on Herpes Zoster Vaccine: Licensure for Persons Aged 50 Through 59 Years." MMWR 60.44 Nov. 11, 2011: 1528. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a5.htm>.


Medically Reviewed by a Doctor on 3/28/2013

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Source: MedicineNet.com
http://www.medicinenet.com/postherpetic_neuralgia/article.htm

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