Post-herpetic neuralgia (PHN) following acute shingles is a significant
cause of neuropathic pain especially in the elderly. Early treatment
with antiviral agents, such as aciclovir reduces the incidence and duration
of PHN in some patients. The physician who first sees a patient with
shingles needs to identify and treat patients who are most likely to
develop long-term pain. Although more expensive, famciclovir and valaciclvoir
may be better medications for reducing PHN than shorter acting aciclovir.
Predicting which patients are likely to develop PHN would also make
evaluating of early use of antiepileptic, anti-inflammatory and analgesic
agents in the prevention of PHN easier. In studying 280 patients with
shingles, the investigators evaluated the use of five clinical factors
to predict the occurrence of PHN. A score over 5 and/or age over 50
years correctly identified all patients with PHN at 3 and 6 months,
respectively. However, most patients aged 50 and over recovered within
3 and 6 months, respectively. The researchers conclude that better methods
are needed to identify patients over 50 at high risk for PHN, so physicians
can better allocate resources in treating shingles. Coen PG, Scott F,
Leedham-Green M, Nia T, Jamil A, Johnson RW, Breuer, J. Adapted from
Eur J Pain. 2006 Jan 19.
PMID 16427792
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
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Library of Medicine (NLM).
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