TREATMENT OF POSTHERPETIC NEURALGIA

  • Rute Teotónio Interna do Internato Complementar de Neurologia, Serviço de Neurologia, Centro Hospitalar Universitário de Coimbra/ Resident of Neurology, Neurology Department, Centro Hospitalar Universitário de Coimbra.
  • Ana Brinca Interna do Internato Complementar de Dermatovenerologia, Serviço de Dermatologia, Centro Hospitalar Universitário de Coimbra / Resident of Dermatology, Dermatology Department, Centro Hospitalar Universitário de Coimbra. Portugal
  • José Carlos Cardoso Assistente Hospitalar de Dermatovenerologia, Serviço de Dermatologia, Centro Hospitalar Universitário de Coimbra/ Consultant of Dermatology, Dermatology Department, Centro Hospitalar Universitário de Coimbra. Portugal
  • Bruno Rodrigues Assistente Hospitalar de Neurologia, Serviço de Neurologia, Centro Hospitalar Universitário de Coimbra/ Consultant of Neurology, Neurology Department, Centro Hospitalar Universitário de Coimbra, Portugal

Abstract

Postherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities.

KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. 

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Published
2013-04-20
How to Cite
Teotónio, R., Brinca, A., Cardoso, J. C., & Rodrigues, B. (2013). TREATMENT OF POSTHERPETIC NEURALGIA. Journal of the Portuguese Society of Dermatology and Venereology, 70(4), 451-457. https://doi.org/10.29021/spdv.70.4.98
Section
Review Articles