title: Improvement of postherpetic neuralgia after treatment with intravenous acyclovir followed by oral valacyclovir.
abstract: BACKGROUND
  Postherpetic neuralgia (PHN) is a complication of shingles (herpes zoster), a painful rash due to varicella-zoster virus reactivation. Studies of patients with PHN and zoster sine herpete (radicular pain without rash) support the notion that low-grade viral ganglionitis contributes to pain. If chronic pain reflects active infection, then antiviral therapy may help patients with PHN.
  
  
  OBJECTIVE
  To determine whether antiviral treatment helps reduce PHN-associated pain.
  
  
  METHODS
  Prospective, open-label phase I/II clinical trial.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Fifteen patients with moderate to severe PHN.
  
  
  METHODS
  Intravenous acyclovir at a dosage of 10 mg/kg every 8 hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times per day for 1 month.
  
  
  METHODS
  Numeric Rating Scale for Pain score.
  
  
  RESULTS
  As defined by a decrease of 2 or more points on the Numeric Rating Scale for Pain, 8 (53%) of 15 patients reported improvement.
  
  
  CONCLUSIONS
  Clinical improvement reported by most of our patients warrants further investigation in a larger, randomized, double-blind, placebo-controlled trial.
authors: Department of Neurology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
authors: Dianna
authors: D
authors: Quan
authors: Barbara N
authors: BN
authors: Hammack
authors: John
authors: J
authors: Kittelson
authors: Donald H
authors: DH
authors: Gilden