Related Experiment Video
Updated: Jul 10, 2026
09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Postherpetic neuralgia: epidemiology, pathophysiology and management
Robert W Johnson1, Gunnar Wasner, Patricia Saddier
1Bristol Royal Infirmary, University of Bristol, Bristol, UK. r.w.johnson@bris.ac.uk
Expert Review of Neurotherapeutics
|November 14, 2007
Summary
Postherpetic neuralgia (PHN) is a common shingles complication. A zoster vaccine can reduce the incidence of shingles and PHN, offering a promising preventative strategy.
Area of Science:
- Neurology
- Immunology
- Pain Medicine
Background:
- Postherpetic neuralgia (PHN) is the most frequent complication of herpes zoster (HZ), or shingles.
- PHN primarily affects older adults (≥60 years), especially those with severe acute HZ pain and rash.
- Antiviral drugs can shorten the duration of HZ-associated pain.
Purpose of the Study:
- To review the pathophysiology, treatment, and prevention of postherpetic neuralgia.
- To highlight the increasing incidence of HZ and PHN due to aging populations and immunosuppression.
- To emphasize the role of the zoster vaccine in mitigating HZ and PHN.
Main Methods:
- Literature review of studies on herpes zoster and postherpetic neuralgia.
- Analysis of current therapeutic strategies for PHN.
- Evaluation of the impact of the zoster vaccine on HZ and PHN incidence.
Main Results:
- PHN pathophysiology may differ based on skin sensitivity.
- Current treatments include tricyclic drugs, gabapentin, opiates, and topical agents.
- The incidence of HZ and PHN is projected to rise.
Conclusions:
- Mechanism-based therapies for PHN remain a challenge.
- The zoster vaccine effectively reduces the incidence and burden of HZ and PHN.
- Vaccination is a key strategy for preventing PHN in adults.
Related Concept Videos
01:20Chickenpox
Chickenpox is an acute, highly contagious disease caused by the varicella-zoster virus (VZV), a double-stranded DNA virus belonging to the Herpesviridae family. Its transmission occurs primarily through the inhalation of respiratory droplets or direct contact with vesicular fluid from skin lesions. The incubation period typically ranges from 10 to 21 days, during which the virus replicates and disseminates through sequential phases within the host. Although generally self-limiting in children,...
01:28Herpes
Herpes simplex type 1 (HSV‑1) is a widespread pathogen responsible for orolabial lesions. It is an enveloped, double-stranded DNA (dsDNA) virus belonging to the family Herpesviridae. Once the virus infects a host cell, its double‑stranded DNA genome is delivered into the nucleus, where a coordinated cascade of immediate‑early, early, and late gene expression directs viral DNA replication, structural protein synthesis, and virion assembly. After primary infection of epithelial cells, HSV-1...
01:23Genital Herpes
Genital herpes is a sexually transmitted infection primarily caused by herpes simplex virus type 2 (HSV-2), though herpes simplex virus type 1 (HSV-1) is increasingly implicated in genital infections, particularly among younger populations. Transmission occurs mainly through sexual contact, with asymptomatic viral shedding serving as a major route of spread. This characteristic makes HSV-2 difficult to control at a population level, as individuals may unknowingly transmit the virus even in the...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:23Degenerative Disc Disease ll: Pathophysiology
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...