Korean J Pain.  2018 Oct;31(4):235-243. 10.3344/kjp.2018.31.4.235.

Modalities in managing postherpetic neuralgia

• Shrestha M
• Chen A

• KMID: 2421514
• DOI: http://doi.org/10.3344/kjp.2018.31.4.235

Abstract

Postherpetic neuralgia (PHN) is the most troublesome side effect of Herpes Zoster (HZ), which mainly affects the elderly and immunocompromised populations. Despite the current advancement of treatments, PHN persists in many individuals influencing their daily activities and reducing their quality of life. Anticonvulsants, antidepressants, topical therapies including lidocaine and capsaicin, and opioids, are the most widely used therapies for the treatment of PHN. These medications come with their adverse effects, so they should be used carefully with the elderly or with patients with significant comorbidities. Other measures like botulinum toxin, nerve blocks, spinal cord stimulation, and radiofrequency have also contributed significantly to the management of PHN. However, the efficacy, safety, and tolerability of these invasive methods need to be carefully monitored when administering them. Early diagnosis and early initiation of treatment can reduce the burden associated with PHN. The zoster vaccine has effectively reduced the incidence of HZ and PHN. In this article, we discuss the treatment options available for the management of PHN, mainly focusing on the efficacy and safety of different therapeutic modalities.

Keyword

Aged; Anticonvulsants; Antidepressants; Botulinum toxin; Capsaicin; Herpes zoster vaccination; Incidence; Nerve block; Opioids; Postherpetic neuralgia; Quality of life; Spinal cord stimulation

MeSH Terms

Aged
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Botulinum Toxins
Capsaicin
Comorbidity
Early Diagnosis
Herpes Zoster
Herpes Zoster Vaccine
Humans
Incidence
Lidocaine
Nerve Block
Neuralgia, Postherpetic*
Quality of Life
Spinal Cord Stimulation
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Botulinum Toxins
Capsaicin
Herpes Zoster Vaccine
Lidocaine

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