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Post-herpetic neuralgia: further post-mortem studies of cases with and without pain
C P N Watson1, J H Deck, C Morshead
1Irene Eleanor Smythe Pain Clinic, Toronto General Hospital, Toronto, Ont. M5G 2C4 Canada Department of Pathology, Toronto General Hospital, Toronto, Ont. M5G 2C4 Canada Neurobiology Research Group, Department of Anatomy, University of Toronto, Toronto, Ont. M5S 1A8 Canada.
Abstract:
The pathological features associated with post-herpetic neuralgia require further study. We report here 5 cases, 3 with severe post-herpetic neuralgia (PHN) and 2 with no persistent pain. The findings of dorsal horn atrophy and cell, axon and myelin loss with fibrosis in the sensory ganglion were found only in patients with persistent pain. Marked loss of myelin and axons in the nerve and/or sensory root were found in cases with and without pain. Some evidence is presented for a more generalized subacute or chronic inflammatory process which may explain the clinical features of some patients. Further studies will be necessary to fully describe the morbid anatomy of this disorder.