Postgerpeticheskie nevralgii (nevropatii), obuslovlennye opoyasyvayushchim gerpesom


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Abstract

The most common complication of herpes zoster is postherpetic neuralgia (neuropathy). Pain that lasts for more than 3 months after the onset of herpes zoster infection is called postherpetic neuralgia. The incidence of postherpetic neuralgia depends on the patients age: 50-75 % of patients in the seventh decade develop postherpetic neuralgia after an infection with herpes zoster. The clinical appearance of postherpetic neuralgia is characteristic. Three different pain types can be distinguished: 1. spontaneous, constant, burning pain, 2. intermittent sharp pain, 3. pain in response to a normally non-painful stimulus. Other phenomena which can be observed are hyp- or anaesthesia, and dysaesthesia. In 20 % of all cases of herpes zoster, the innervations territory of the ophthalmic nerve is affected. Ramsay Hunt syndrome is a special form of herpes zoster which is typically characterized by peripheral facial palsy and unilateral herpetic vesicles on the ear. These symptoms are often accompanied by vestibulocochlear dysfunction and other neurological symptoms. Management options include early antiviral treatment and gabapentinoids, tricyclic antidepressants, controlled release opioids.

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