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Updated: Jun 6, 2026
09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
[Postherpetic neuralgia]
Kazuo Higa1, Shinjiro Shono, Keiichi Nitahara
1Department of Anesthesiology, Fukuoka University Faculty of Medicine, Fukuoka 814-0180.
Masui. the Japanese Journal of Anesthesiology
|November 17, 2010
Summary
Varicella-zoster virus (VZV) reactivation causes shingles and postherpetic neuralgia (PHN) in older adults. Vaccination significantly reduces the incidence of both VZV diseases and PHN.
Area of Science:
- Virology
- Immunology
- Epidemiology
Context:
- Varicella-zoster virus (VZV) causes varicella and herpes zoster.
- Herpes zoster, a recurrent VZV infection, arises from declining cell-mediated immunity, particularly with aging.
- Postherpetic neuralgia (PHN) is the most common complication of herpes zoster.
Purpose:
- To review the treatment and prevention strategies for postherpetic neuralgia (PHN).
- To evaluate the efficacy of current PHN treatments and explore preventative measures.
- To highlight the role of vaccination in managing VZV-related complications.
Summary:
- First-line treatments for PHN include amitriptyline, nortriptyline, gabapentin, and pregabalin.
- Opioids may be considered for refractory PHN, while neuroablative procedures lack confirmed efficacy.
- A live attenuated varicella vaccine demonstrated a nearly 50% reduction in herpes zoster and PHN incidence compared to placebo.
Impact:
- Vaccination represents the most effective strategy for preventing PHN, especially in high-risk populations.
- Understanding VZV pathophysiology and immunity is crucial for developing effective interventions.
- This review informs clinical practice regarding PHN management and prevention through vaccination.
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