[Herpes zoster and post-herpetic neuralgia].
Pain associated with herpes zoster arise from the virul neuritis of the suffered trigeminal or spinal dorsal ganglion. Prolonged neuritis makes an irreversible nerve injury and continuous pain impulse develops a central sensitization. A post-herpetic neuralgia is thought to be a neuropathic pain due to the irreversible nerve injury and sensitization. It is important to treat herpetic pain completely before the development of the post-herpetic neuralgia, because there are few effective therapies to cure post-herpetic neuralgia. A sympathetic nerve block increases the nerve blood flow supply, and may improve the nerve injury. It is also known that some sympathetic mechanisms relate to the development of the sensitization. A sensory nerve block reduces pain impulse to the dorsal horn, and may interfere the sensitization. A cortico-steroid administrated with a nerve block can reduce the neuritis, and may improve the nerve injury.
Hashizume
K
K
Department of Anesthesiology, Nara Medical University.
D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001340:Autonomic Nerve Block; D002220:Carbamazepine / Q000627:therapeutic use; D004824:Epidural Space; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use; D009407:Nerve Block; D009437:Neuralgia / Q000209:etiology* / Q000628:therapy*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D013233:Stellate Ganglion; D014276:Trigeminal Nerve
D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D016194:Receptors, N-Methyl-D-Aspartate; D002220:Carbamazepine; D007649:Ketamine