Display options
Cite
Zenz T, Zenz M, Tryba M. Schmerztherapie bei Herpes zoster und postzosterischer Neuralgie. [Pain therapy in herpes zoster and post-zoster neuralgia.]. Schmerz. 1994;8(1):24-36doi: 10.1007/BF02527507.
Zenz, T., Zenz, M., & Tryba, M. (1994). Schmerztherapie bei Herpes zoster und postzosterischer Neuralgie. [Pain therapy in herpes zoster and post-zoster neuralgia.]. Schmerz (Berlin, Germany), 8(1), 24-36. https://doi.org/10.1007/BF02527507
Zenz, T, et al. "Schmerztherapie bei Herpes zoster und postzosterischer Neuralgie." [Pain therapy in herpes zoster and post-zoster neuralgia.]. Schmerz (Berlin, Germany) vol. 8,1 (1994): 24-36. doi: https://doi.org/10.1007/BF02527507
Zenz T, Zenz M, Tryba M. Schmerztherapie bei Herpes zoster und postzosterischer Neuralgie. [Pain therapy in herpes zoster and post-zoster neuralgia.]. Schmerz. 1994 Mar;8(1):24-36. doi: 10.1007/BF02527507. German. PMID: 18415452.
Copy Download .nbib Format: NLM
Share it on

Schmerz. 1994 Mar;8(1):24-36. doi: 10.1007/BF02527507.

[Pain therapy in herpes zoster and post-zoster neuralgia.].

Schmerz (Berlin, Germany)

[Article in German]
T Zenz, M Zenz, M Tryba

Affiliations

  1. Universitätsklinik für Anästhesiologie, Intensiv- und Schmerztherapie, BG-Kliniken Bergmannsheil, Gilsingstraße 14, D-44789, Bochum.

PMID: 18415452 DOI: 10.1007/BF02527507

Abstract

Herpes zoster neuralgia and post-zoster neuralgia (PZN) are common disabling pain syndromes. While pain from acute herpes zoster is self-limited in most cases, as pain may disappear without treatment, post-zoster neuralgia is difficult to manage. Pathological findings in acute herpes zoster include infiltration of ganglia, demyelinization and loss of axons; yet the pathogenesis of pain remains largely unknown. In postzoster (often incorrectly called post-herpetic) neuralgia, peripheral and central origins are mentioned for the development of pain: selective loss of myelin-sheathed nerve fibres, sensitization of peripheral nociceptors, cross-talk between afferents and sympathetic efferents, deafferentation with somatotopic remodeling, virus-induced spontaneous activity, and nociceptive nervi nervorum. Pain shows no sex-specific differences, but there is a clear predominance in elderly patients over 60 years of age. In these patients aggressive therapy should be instituted. Numerous pharmacological, anesthetic and surgical approaches have been proposed for the treatment of pain in herpes zoster. Most approaches have been studied in uncontrolled settings. Treatment is most effective when installed early in the course of the disease. For acute zoster pain, treatment with acyclovir, glucocorticosteroids and sympathetic blocks reveal the best results. PZN of less than 3 months' duration should be treated with sympathetic blocks. Long-standing PZN resolves in two-thirds of the cases when treated with tricyclic antidepressants. TENS may be tried concomitantly. Topical ASA and capsaicin show promising effects and should be the object of further investigation. The same is true for specific zoster hyperimmunoglobulins and non-specific immunoglobulins; however, there are no definite results. In the future, controlled, double-blind studies on the effect of therapeutic measures in preventing postzosteric neuralgia need to be conducted. So far, the positive effect of sympathetic blocks in preventing the late pain complications of herpes zoster can only be suggested and recommended based on subjective experience.

References

  1. Eur Neurol. 1985;24(6):380-5 - PubMed
  2. JAMA. 1970 Mar 9;211(10):1681-3 - PubMed
  3. J Am Acad Dermatol. 1989 Aug;21(2 Pt 1):265-70 - PubMed
  4. Acta Derm Venereol. 1969;49(6):569-83 - PubMed
  5. N Engl J Med. 1986 Jan 23;314(4):208-12 - PubMed
  6. Reg Anesth. 1993 Sep-Oct;18(5):271-3 - PubMed
  7. Reg Anesth. 1993 Sep-Oct;18(5):277-82 - PubMed
  8. BMJ. 1988 Nov 12;297(6658):1215-6 - PubMed
  9. Am J Med. 1988 Aug 29;85(2A):79-83 - PubMed
  10. Int J Neurosci. 1979;9(3):191-4 - PubMed
  11. Br Med J. 1974 Sep 14;3(5932):645-7 - PubMed
  12. Anesth Analg. 1985 Oct;64(10):971-4 - PubMed
  13. Surg Neurol. 1981 Feb;15(2):102-4 - PubMed
  14. Arch Neurol. 1966 Aug;15(2):129-36 - PubMed
  15. Pain. 1989 May;37(2):223-227 - PubMed
  16. J Neurol Neurosurg Psychiatry. 1990 Feb;53(2):135-41 - PubMed
  17. Clin Exp Dermatol. 1984 Nov;9(6):557-63 - PubMed
  18. Clin J Pain. 1989 Dec;5(4):295-300 - PubMed
  19. Anaesthesia. 1981 Feb;36(2):210-2 - PubMed
  20. Neurology. 1961 Feb;11:170-1 - PubMed
  21. Anesthesiology. 1987 Sep;67(3):441-2 - PubMed
  22. Am J Med. 1988 Aug 29;85(2A):84-9 - PubMed
  23. Pain. 1991 Aug;46(2):195-199 - PubMed
  24. Med J Aust. 1965 Nov 20;2(21):869-72 - PubMed
  25. Anesth Analg. 1988 Sep;67(9):897-9 - PubMed
  26. Calif Med. 1965 Oct;103(4):277-9 - PubMed
  27. Medicine (Baltimore). 1982 Sep;61(5):310-6 - PubMed
  28. Postgrad Med J. 1972 Oct;48(564):594-8 - PubMed
  29. Pain. 1986 May;25(2):165-170 - PubMed
  30. Pain. 1993 Mar;52(3):259-285 - PubMed
  31. N Engl J Med. 1983 Dec 8;309(23):1434-40 - PubMed
  32. Ann Intern Med. 1950 Feb;32(2):257-60 - PubMed
  33. Biomed Pharmacother. 1990;44(9):455-9 - PubMed
  34. J Am Acad Dermatol. 1988 Mar;18(3):605-10 - PubMed
  35. J Pediatr. 1982 Jul;101(1):125-31 - PubMed
  36. Pain. 1990 Apr;41(1):61-69 - PubMed
  37. Pain. 1991 Feb;44(2):105-117 - PubMed
  38. J Neurosurg. 1975 Mar;42(3):308-14 - PubMed
  39. Arch Surg. 1978 Mar;113(3):253-4 - PubMed
  40. Proc R Soc Med. 1973 Jun;66(6):541-3 - PubMed
  41. Anaesthesist. 1994 Jan;43(1):53-4 - PubMed
  42. Ann Surg. 1949 Oct;130(4):622-35 - PubMed
  43. Pain. 1983 Dec;17(4):361-368 - PubMed
  44. Anesthesiology. 1987 Jan;66(1):73-6 - PubMed
  45. Appl Neurophysiol. 1982;45(1-2):179-84 - PubMed
  46. Pain. 1989 Nov;39(2):129-144 - PubMed
  47. Anaesthesist. 1992 Dec;41(12):772-8 - PubMed
  48. J Am Geriatr Soc. 1971 Jun;19(6):495-504 - PubMed
  49. Clin Pharmacol Ther. 1990 Mar;47(3):305-12 - PubMed
  50. Neurology. 1988 Sep;38(9):1427-32 - PubMed
  51. Br Med J. 1957 Jan 12;1(5010):84-7 - PubMed
  52. Scand J Infect Dis. 1981;13(4):257-62 - PubMed
  53. Scand J Infect Dis. 1975;7(1):1-5 - PubMed
  54. Pain. 1985 Dec;23(4):387-394 - PubMed
  55. Pain. 1990 Feb;40(2):131-135 - PubMed
  56. Pain. 1985 Dec;23(4):381-386 - PubMed
  57. Scand J Infect Dis. 1979;11(1):1-9 - PubMed
  58. Lancet. 1964 Sep 19;2(7360):610-1 - PubMed
  59. Clin J Pain. 1989 Sep;5(3):271-4 - PubMed
  60. N Engl J Med. 1976 May 27;294(22):1193-9 - PubMed
  61. Pain. 1992 Jan;48(1):29-36 - PubMed
  62. Pain. 1988 Dec;35(3):368-369 - PubMed
  63. Pain. 1989 Dec;39(3):301-305 - PubMed
  64. Neurology. 1989 Aug;39(8):1132-3 - PubMed
  65. Pain. 1992 Mar;48(3):383-390 - PubMed
  66. JAMA. 1981 Jul 10;246(2):132-4 - PubMed
  67. Pain. 1990 Jan;40(1):29-34 - PubMed
  68. BMJ. 1989 Feb 18;298(6671):431 - PubMed
  69. J Auton Nerv Syst. 1983 Mar-Apr;7(3-4):371-84 - PubMed
  70. Arch Neurol. 1986 Aug;43(8):836-40 - PubMed
  71. Ann Neurol. 1983 Apr;13(4):462-5 - PubMed
  72. JAMA. 1961 Jun 24;176:1041-3 - PubMed
  73. J Neurol. 1991 Dec;238(8):452-6 - PubMed
  74. Lancet. 1987 Aug 15;2(8555):366-8 - PubMed
  75. Lancet. 1982 Jul 17;2(8290):118-21 - PubMed
  76. Br J Dermatol. 1981 Mar;104(3):351-2 - PubMed
  77. Lancet. 1987 Jul 18;2(8551):126-9 - PubMed
  78. Arch Dermatol. 1984 Jun;120(6):747-50 - PubMed
  79. Curr Med Res Opin. 1990;12(3):169-76 - PubMed
  80. AMA Arch Derm. 1955 Apr;71(4):488-91 - PubMed
  81. AMA Arch Derm. 1957 Feb;75(2):193-6 - PubMed
  82. Pain. 1988 Apr;33(1):73-78 - PubMed
  83. Pain. 1980 Dec;9(3):355-362 - PubMed
  84. Pain. 1988 Aug;34(2):129-138 - PubMed
  85. Scand J Infect Dis. 1989;21(1):15-8 - PubMed
  86. Pain. 1988 Dec;35(3):289-297 - PubMed
  87. J Pain Symptom Manage. 1992 Feb;7(2):69-77 - PubMed
  88. Histochemistry. 1980;70(1):1-6 - PubMed
  89. Proc R Soc Med. 1965 Jan;58:9-20 - PubMed
  90. DICP. 1991 Apr;25(4):381-7 - PubMed
  91. DICP. 1991 Oct;25(10):1077-9 - PubMed
  92. Pain. 1988 Jun;33(3):333-340 - PubMed
  93. Arch Neurol. 1968 Aug;19(2):129-36 - PubMed
  94. Can Anaesth Soc J. 1978 May;25(3):218-25 - PubMed
  95. Neurology. 1964 Aug;14:744-50 - PubMed
  96. Ann Neurol. 1984 Sep;16(3):265-77 - PubMed
  97. Appl Neurophysiol. 1988;51(2-5):218-24 - PubMed
  98. Reg Anesth. 1990 May-Jun;15(3):113-7 - PubMed
  99. Ann Neurol. 1986 Dec;20(6):651-64 - PubMed
  100. Stereotact Funct Neurosurg. 1989;53(1):40-5 - PubMed
  101. Proc Natl Acad Sci U S A. 1977 Dec;74(12):5716-20 - PubMed
  102. Am Fam Physician. 1975 Nov;12(5):142-4 - PubMed
  103. Br J Dermatol. 1980 May;102(5):551-5 - PubMed
  104. Nature. 1978 Apr 13;272(5654):583-5 - PubMed
  105. JAMA. 1985 Mar 8;253(10):1444-5 - PubMed
  106. Anaesthesist. 1991 Oct;40(10):523-9 - PubMed
  107. Science. 1968 May 24;160(3830):896-8 - PubMed
  108. Neurology. 1991 Jul;41(7):1024-8 - PubMed
  109. Pain. 1978 Dec;5(4):367-371 - PubMed
  110. JAMA. 1985 Mar 8;253(10):1427-30 - PubMed
  111. J Neurosurg. 1984 Jun;60(6):1258-62 - PubMed
  112. Am J Kidney Dis. 1992 Dec;20(6):647-9 - PubMed
  113. Pain. 1986 May;25(2):149-164 - PubMed
  114. N Engl J Med. 1982 Oct 14;307(16):971-5 - PubMed
  115. Clin J Pain. 1990 Dec;6(4):284-90 - PubMed
  116. Psychosomatics. 1990 Summer;31(3):287-92 - PubMed
  117. Acta Neuropathol. 1980;52(1):59-68 - PubMed
  118. Acta Neurol Scand. 1991 Aug;84(2):146-52 - PubMed
  119. J R Coll Gen Pract. 1975 Aug;25(157):571-5 - PubMed
  120. Lancet. 1957 Feb 2;272(6962):242-5 - PubMed
  121. N Engl J Med. 1978 May 4;298(18):981-7 - PubMed
  122. N Z Med J. 1981 Nov 25;94(696):384-6 - PubMed
  123. Lancet. 1990 May 26;335(8700):1279 - PubMed
  124. J Am Med Assoc. 1957 May 18;164(3):265-9 - PubMed
  125. South Med J. 1976 May;69(5):576-8 - PubMed
  126. J Neurosurg. 1973 Aug;39(2):235-9 - PubMed
  127. Acta Derm Venereol. 1990;70(2):121-5 - PubMed
  128. Neurology. 1962 Oct;12:725-7 - PubMed
  129. Science. 1965 Nov 19;150(3699):971-9 - PubMed
  130. Anesthesiology. 1992 Jun;76(6):1065-6 - PubMed
  131. Anaesthesia. 1985 Nov;40(11):1133-4 - PubMed
  132. Lancet. 1980 Aug 30;2(8192):474 - PubMed
  133. Clin Pharmacol Ther. 1988 Apr;43(4):363-71 - PubMed
  134. Nephron. 1992;62(3):280-3 - PubMed
  135. Neurology. 1982 Jun;32(6):671-3 - PubMed
  136. Am J Med Sci. 1993 Jan;305(1):36-9 - PubMed

Publication Types