Synonyms:
Post zoster neuralgia VZV:
Diagnosis:
Persistence of the pain of herpes zoster more than 3 months after resolution of the rash.
Zoster-associated pain: the continuum of pain from acute herpes zoster to the development of postherpetic neuralgia.
Treatment:
Best medications:
- Tricyclic antidepressants:
- Nortriptyline, amitriptyline, desipramine, and maprotiline
- Antiepileptics:
- Gabapentin GBP, pregabalin
- Opioids:
- Oxycodone or morphine sulfate sustained release
- Topical lidocaine patches
Others:
- Capsiacin topical, but takes longer to act
If the above fail:
- Consider preservative free methylprednisolone intrathecally
Prevention:
- Use of antivirals within 72 hours of onset of VZV infection