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Postherpetic neuralgia

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There is moderate evidence as to the efficacy of the use of botulinum toxin to treat trigeminal neuralgia and postherpetic neuralgia.
October 21, 2016: British Dental Journal
Cynthia L Huffman, James N Goldenberg, James Weintraub, Luis Sanin, Joseph Driscoll, Ruoyong Yang, Marci L Chew, Joseph M Scavone
OBJECTIVES: To assess efficacy and safety of once-daily controlled-release (CR) formulation of pregabalin in patients with postherpetic neuralgia (PHN). METHODS: A randomized withdrawal trial, with 6-week single-blind pregabalin treatment phase and 13-week double-blind phase, where patients with ≥50% decrease in mean pain score at single-blind end point from baseline were randomized (1:1) to pregabalin CR (82.5-660 mg d) or placebo. Primary efficacy outcome was time to loss of therapeutic response (LTR; <30% decrease in weekly mean pain score from single-blind baseline or discontinuation due to adverse event [AE] or lack of efficacy)...
October 6, 2016: Clinical Journal of Pain
Sheena Derry, Cathy Stannard, Peter Cole, Philip J Wiffen, Roger Knaggs, Dominic Aldington, R Andrew Moore
BACKGROUND: Opioid drugs, including fentanyl, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for fentanyl, at any dose, and by any route of administration. Other opioids are considered in separate reviews. OBJECTIVES: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials...
October 11, 2016: Cochrane Database of Systematic Reviews
Wen-Yi Wang, Sing-Huh Liu, Meng-Yin Lin, Che-Chen Lin, I-Jong Wang
Herpes zoster (HZ) is associated with complications such as postherpetic neuralgia (PHN) and HZ ophthalmicus (HZO). However, few studies have focused on identifying patients having a high risk of PHN and HZO according to the initial presentation sites. The current study investigated these factors in a nationwide population-based cohort derived from Taiwan's Longitudinal Health Insurance Database. The results indicate that the initial presentation sites can predict the complication site of HZ. In this study, elderly patients were found to be more susceptible to HZ and were the first to present with neurological signs (HZN)...
2016: PloS One
Theresa Mallick-Searle, Brett Snodgrass, Jeannine M Brant
Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox) virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation...
2016: Journal of Multidisciplinary Healthcare
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
Panagiotis Zis, Nikolitsa Bernali, Erifili Argira, Ioanna Siafaka, Athina Vadalouka
BACKGROUND: Capsaicin 8% patch (Qutenza™) is mainly used to treat postherpetic neuralgia and HIV-associated neuropathy. Evidence of the efficacy of Qutenza in other forms of neuropathic pain is lacking. OBJECTIVE: To evaluate the analgesic effect and the impact on quality of life after a single application of the capsaicin 8% cutaneous patch in patients with lumbosacral pain. STUDY DESIGN: Prospective open-label study of capsaicin 8% patch in patients with lumbosacral pain...
September 2016: Pain Physician
Yu Shi, Wen Wu
BACKGROUND: Neuropathic pain (NP) is a major public health problem worldwide. Because of the unclear mechanism of NP, its treatment is one of the most difficult medical problems. As a targeted, noninvasive, safe therapy, pulsed radiofrequency (PRF) provides a new method for the treatment of NP; however, its effect on this treatment still lacks support from evidence-based medicine. OBJECTIVE: To conduct a meta-analysis of available randomized controlled trials and to evaluate the effectiveness and clinical utility of PRF for the treatment of NP...
September 2016: Pain Physician
Anthony L Cunningham, Himal Lal, Martina Kovac, Roman Chlibek, Shinn-Jang Hwang, Javier Díez-Domingo, Olivier Godeaux, Myron J Levin, Janet E McElhaney, Joan Puig-Barberà, Carline Vanden Abeele, Timo Vesikari, Daisuke Watanabe, Toufik Zahaf, Anitta Ahonen, Eugene Athan, Jose F Barba-Gomez, Laura Campora, Ferdinandus de Looze, H Jackson Downey, Wayne Ghesquiere, Iris Gorfinkel, Tiina Korhonen, Edward Leung, Shelly A McNeil, Lidia Oostvogels, Lars Rombo, Jan Smetana, Lily Weckx, Wilfred Yeo, Thomas C Heineman
Background A trial involving adults 50 years of age or older (ZOE-50) showed that the herpes zoster subunit vaccine (HZ/su) containing recombinant varicella-zoster virus glycoprotein E and the AS01B adjuvant system was associated with a risk of herpes zoster that was 97.2% lower than that associated with placebo. A second trial was performed concurrently at the same sites and examined the safety and efficacy of HZ/su in adults 70 years of age or older (ZOE-70). Methods This randomized, placebo-controlled, phase 3 trial was conducted in 18 countries and involved adults 70 years of age or older...
September 15, 2016: New England Journal of Medicine
Silvia Coretti, Paola Codella, Federica Romano, Matteo Ruggeri, Americo Cicchetti
OBJECTIVES: Herpes zoster (HZ) is characterized by a painful skin rash. Its main complication is postherpetic neuralgia (PHN), pain persisting or occurring after the rash onset. HZ treatment aims to reduce acute pain, impede the onset complications, and disease progression. The aim of this study was to assess the cost-effectiveness of HZ vaccination compared with no vaccination strategy, within the Italian context. METHODS: The natural history of HZ and PHN was mapped through a Markov model with lifetime horizon...
September 14, 2016: International Journal of Technology Assessment in Health Care
Albert J M van Wijck, Yannick R Aerssens
BACKGROUND: Herpes zoster (HZ) and postherpetic neuralgia are known to have a profound effect on the patient's quality of life, but the incidence and severity of itch and its relation with pain and quality of life in the long term are still relatively unknown. OBJECTIVE: The aim of this study was to measure the presence and severity of pain and itch and impact on quality of life in patients over 50 years old with HZ. METHODS: We enrolled 661 patients with HZ in this 12-month observational study...
September 9, 2016: Pain Practice: the Official Journal of World Institute of Pain
Concepción Pérez, Mark Latymer, Mary Almas, Marie Ortiz, Andrew Clair, Bruce Parsons, Roxana Varvara
BACKGROUND: Patients with chronic pain conditions such as neuropathic pain frequently experience delays in diagnosis and treatment. Ideally, all patients should be treated in a timely manner, but in those patients with more established disease it is important to know that approved treatments remain effective. METHODS: This was a pooled analysis of 19 randomized placebo-controlled trials of pregabalin for peripheral neuropathic pain conditions, including diabetic peripheral neuropathy, postherpetic neuralgia, and post-traumatic/postsurgical pain...
September 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
Yu-Tsung Chen, Hsiao-Han Wang, Tsung-Jen Wang, Yu-Chuan Li, Ting-Jui Chen
BACKGROUND: Postherpetic neuralgia (PHN) is difficult to treat, and currently there are no available treatments that effectively reduce its incidence. Low-level laser therapy (LLLT) has been proposed for indirect virus deactivation in treating recurrent herpes simplex infections. OBJECTIVE: This study seeks to investigate whether LLLT could reduce the incidence of PHN. METHODS: We retrospectively reviewed the incidence of PHN at the first, third, and sixth months after rash outbreak in 3 groups: the acute group of patients who received LLLT during the first 5 days; the subacute group of patients who received LLLT during days 6 to 14 of the eruption; and the control group of patients who did not receive LLLT...
September 2016: Journal of the American Academy of Dermatology
Kevin J Friesen, Jamie Falk, Silvia Alessi-Severini, Dan Chateau, Shawn Bugden
BACKGROUND: Pain is a main symptom of herpes zoster (HZ), and postherpetic neuralgia (PHN) is a frequent complication occurring in 5% to 15% of cases, causing moderate to severe neuropathic pain. A population-based observational study was conducted to evaluate the treatment patterns and economic burden of prescription drug treatment of HZ and PHN pain in the province of Manitoba (Canada) over a period of 15 years. METHODS: Administrative health care data, including medical and hospital separation records, were examined to identify episodes of HZ using International Classification of Diseases-9/10 codes between April 1, 1997 and March 31, 2014...
2016: Journal of Pain Research
Yoo Na Kim, Dae Woo Kim, Eung Don Kim
The aim of the present study was to investigate efficacy of continuous epidural block for prevent postherpetic neuralgia (PHN) progression in cases of acute herpes zoster with severe pain and also to identify predictive factors for PHN in such conditions.We retrospectively analyzed the clinical data of patients with herpes zoster who underwent continuous epidural block between March 2013 and October 2015. Time points were set as 1 month, 3 months, and 6 months after zoster onset. PHN was defined as the presence of pain with NRS ≥3 at certain time points...
August 2016: Medicine (Baltimore)
Ram Prasad Koju, Tie-Chi Lei
Postherpetic neuralgia (PHN) is a commonest and difficult-to-manage complication of Herpes zoster. This comparative study included 140 cases of PHN admitted in the department of dermatology in Renmin Hospital of Wuhan University, Wuhan, China, from March 2014 to February 2015, divided into a control and a study group. In addition to the combination of antiviral, analgesic, and neurotrophic agents given to the control group, additional ganglioside GM1 was given to patients in the study group. Pain assessment was performed at the time of admission, and then on the third, seventh and tenth day of treatment, on both groups, using a 10 cm visual analogue scale (VAS)...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ji-Zheng Cui, Xiao-Bao Zhang, Pin Zhu, Zhi-Bin Zhao, Zhu-Sheng Geng, Yun-Hai Zhang, Liang Tian, Heng-Fei Luan, Ji-Ying Feng
BACKGROUND: Treatment of established postherpetic neuralgia (PHN) is difficult and often disappointing. In this study, we assessed the efficacy of repetitive intracutaneous injections with local anesthetics and steroids in acute thoracic herpes zoster (HZ) pain, herpetic eruption, and incidence of PHN. METHODS: Ninety-three patients with acute thoracic HZ were randomly assigned to receive a standard treatment of antiviral medication with p.o. analgesics or the standard treatment with the addition of repetitive intracutaneous injections of a local anesthetic and steroid mixture...
August 4, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jing Li, Lijuan Gao, Kaiyue Sun, Dan Xiao, Wanyi Li, Lan Xiang, Jianhua Qi
ETHNOPHARMACOLOGICAL RELEVANCE: G. rigescens Franch (Long Dan Cao in Chinese) is a well-known TCM herb. It is clinically used with other drugs for the treatment of brain diseases such as epilepsy, postherpetic neuralgia in China. AIM OF STUDY: In our previous study, the 11 dihydroxybenzoates compounds with NGF mimicking activity from G. rigescens Franch were found. In the present study, the neurogenesis and neuroprotection of a mixture of benzoates (n-GS) were investigated in animal level...
August 1, 2016: Journal of Ethnopharmacology
Yuki Nakamura, Fumi Miyagawa, Aiko Okazaki, Yoshinobu Okuno, Yasuko Mori, Hiroyasu Iso, Koichi Yamanishi, Hideo Asada
BACKGROUND: Recurrent herpes zoster (HZ) is thought to be rare, but there have been few large-scale studies of recurrent HZ. OBJECTIVE: We conducted a large-scale prospective cohort study to characterize recurrent HZ. METHODS: We examined 12,522 participants aged 50 years or older in Shozu County and followed them up for 3 years. We compared the incidence of HZ and postherpetic neuralgia, severity of skin lesions and acute pain, cell-mediated immunity, and varicella-zoster virus-specific antibody titer between primary and recurrent HZ...
November 2016: Journal of the American Academy of Dermatology
Sabrina Salah, Lesly Thomas, Saravanan Ram, Glenn T Clark, Reyes Enciso
AIMS: To conduct a systematic review to determine the efficacy of oral medications for the management of postherpetic neuralgia (PHN). METHODS: Three electronic databases were searched: Cochrane Library (up to 7 July 2015), MEDLINE via PubMed (from 1950 to 7 July 2015), and Web of Science (1864 to 7 July 2015). Studies were limited to double-blind, placebo controlled, randomized controlled trials on oral medications used to treat PHN. Risk of bias was independently assessed in duplicate...
2016: Journal of Oral & Facial Pain and Headache
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