The Identification of Risk Factors Associated with Persistent Pain following Herpes Zoster

Whitley, Richard J.; Shukla, Shailja; Crooks, R. J.

doi:10.1086/514274

Cited by 66 publications

(48 citation statements)

References 15 publications

(13 reference statements)

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“…In some studies, the best predictor of persistent pain after herpes zoster was the presence of severe prodromal pain or severe pain at presentation and old age [16][17][18][19][20]. Female gender and cranial or sacral locations were additional risk factors for persistent pain in one of these studies [20].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of time-based short-course acyclovir therapy in treatment of post-herpetic pain

Rasi

Behzadi

Rabet

et al. 2010

J Infect Dev Ctries

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Introduction: Various treatments have been used to manage post-herpetic neuralgia (PHN). Safe and effective therapies to prevent PHN are needed. Methodology: A clinical trial involving 152 patients diagnosed with acute herpes Zoster (HZ) was conducted to determine whether shortcourse acyclovir therapy (800 mg five times a day for four days) can alleviate HZ-associated pain and prevent post-herpetic neuralgia (PHN). The patients were divided into two groups: Group 1 had a rash with a duration of less than 72 hours and Group 2 had a rash with a duration of more than 72 hours. To assess PHN, the patients categorized and assessed the severity of their symptoms using a four-point verbal rating scale (VRS). Results: By the fourth week, 134 out of 152 patients (88.2%) had complete pain response (CPR). Of these, 68 patients (89.5%) were from Group 1 and 66 from Group 2 (86.8%). After four weeks, the mean VRS scores had changed significantly in both groups compared to the scores at the beginning of study (p = 0.001), but there was no difference between the two groups (0.88 ± 0.66 Vs. 0.94 ± 0.72; p = 0.66) After three months no differences were observed in the treatment results between the two groups (0.51 ± 0.13 Vs.0.54 ± 0.19; p = 0.77). Conclusion: Short-course acyclovir therapy is an effective treatment for zoster and its efficacy in patients with a rash duration of more than 72 hours is similar to that in patients with rash duration of less than 72 hours.

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Section: Discussionmentioning

confidence: 99%

The efficacy of time-based short-course acyclovir therapy in treatment of post-herpetic pain

Rasi

Behzadi

Rabet

et al. 2010

J Infect Dev Ctries

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“…Analogous findings have been reported for postherpetic neuralgia. 21 No systematic studies in animals seem to have been performed with this question. It may be speculated that the increase is related to a relative decrease in the plasticity of the nervous system with age and therefore a loss of fine-tuning in the delicate balance that regulates the transmission of nociceptive signals to higher centres.…”

Section: Possible Neurobiological Explanationsmentioning

confidence: 99%

Neuropathic pain after traumatic spinal cord injury – relations to gender, spinal level, completeness, and age at the time of injury

et al. 2004

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Study design: Retrospective register study. Objective: To investigate the predictive value of age at the time of injury, gender, level of injury, and completeness of injury for the development of at level and below level neuropathic pain. Setting: 'Spinalis', a postacute spinal cord injury (SCI) outpatient clinic, serving the greater Stockholm area (Sweden). Method: All patients who visited the clinic in 1995-2000 (402 patients) for the first time were examined. The following items were selected: at-level and below-level neuropathic pain according to the International Association for the Study of Pain (IASP) criteria, age at the time of injury, gender, level of injury according to ASIA, and completeness of injury. Mean time of 6 years after the injury. Results were analysed with w 2 analysis and logistic regression. Results: Of all patients examined, 13% had at level pain and 27% had below level pain. Neuropathic pain was less than half as frequent (26%) in the group aged less than 20 years at the time of injury as in the oldest group (58%). The increasing trend was mainly due to belowlevel pain up to 39 years of age, and due to at-level pain at ages 40 and above at the time of injury. No correlation was observed to gender, level of injury or completeness of injury, except for below level pain, which was associated with complete injury. Conclusion:The results show that neuropathic pain after SCI is common and occurs much more often in patients injured at higher ages. This indicates the importance of neuroanalgetic intervention, in particular for patients injured in higher ages.

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“…Meister et al (13) described the incidence of PHN as 28% after 4-5 weeks. There seems to be no regional, ethnic, or gender difference in the occurrence of HZ and PHN (7,8,14,15,19).…”

Section: Discussionmentioning

confidence: 99%

“…The age above which PHN is more likely to occur was reaffirmed to be 50 yr (Table 2). That critical age has been considered as 40 to 60 yr (8,9,13,15,19).…”

Section: Discussionmentioning

confidence: 99%

“…Attention has been paid to the extent of rash, severity of initial pain, interval between initial pain and initiation of treatment, and duration of intense pain in relation to the risk factors for PHN (3,8,12,13,15,16,(19)(20)(21). The number of vesicles has been used as an index of cutaneous dissemination and visceral involvement (3) or as an indicator of PHN (12).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors of Postherpetic Neuralgia

Herr

2002

J Korean Med Sci

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The investigation was aimed to determine prognostic factors related to postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation. The age (≥50 yr), surface area involved (≥9%), and duration of severe pain (≥4 weeks) might be the main factors that lead to PHN. On the other hand, gender, dermatomal distribution, accompanied systemic conditions, and interval between initial pain and initiation of treatment might not be implicated in PHN. The subjects were orally received antiviral (valacyclovir), tricyclic antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard treatment in the group 1. In addition to the standard medication, lidocaine solution was sub-and/or perilesionally injected in the group 2, while lidocaine plus prilocaine cream was topically applied to the skin lesions in the group 3. The rates of PHN in the 3 treatment groups were not significantly different, suggesting adjuvant anesthetics may not be helpful to reduce the severity of pain.

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The Identification of Risk Factors Associated with Persistent Pain following Herpes Zoster

Cited by 66 publications

References 15 publications

The efficacy of time-based short-course acyclovir therapy in treatment of post-herpetic pain

The efficacy of time-based short-course acyclovir therapy in treatment of post-herpetic pain

Neuropathic pain after traumatic spinal cord injury – relations to gender, spinal level, completeness, and age at the time of injury

Prognostic Factors of Postherpetic Neuralgia

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