Post-herpetic neuralgia: 208 cases.
Two hundred and eight patients with post-herpetic neuralgia (PHN) were assessed in a prospective, longitudinal study designed to evaluate demography, clinical features, treatment results and long-term status. PHN affected both sexes equally increasing in frequency and severity with age. There was a predilection for involvement of the ophthalmic division of the trigeminal nerve and for mid-thoracic dermatomes. The pain descriptors chosen reflected both steady and brief paroxysmal components in most patients. Scarring, sensory loss and the exaggerated sensations of hyperesthesia, dysesthesia and allodynia were common findings. Hyperalgesia and hyperpathia were less common. From these open-label, uncontrolled data, antidepressants (amitriptyline and nortriptyline) appeared useful in about 60% of patients. Topical capsaicin seemed to be a promising new approach. A variety of other pharmacological agents and treatment approaches were less successful. Many patients with PHN even of long standing continued to improve with time.
Watson
Peter N C
PNC
Smythe Pain Clinic, Toronto General Hospital, University of Toronto, Toronto, Ont. M5G 2C4 Canada.
Evans
Ramon J
RJ
Watt
Verna R
VR
Birkett
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D010640:Phenothiazines / Q000627:therapeutic use; D004561:Transcutaneous Electric Nerve Stimulation; D014276:Trigeminal Nerve / Q000503:physiopathology*
D000927:Anticonvulsants; D000928:Antidepressive Agents; D010640:Phenothiazines; C031637:phenothiazine