[Herpes zoster neuralgia--a persistent therapeutic problem]

Most patients with acute herpes zoster (AHN) who are younger than 50 yrs recover spontaneously and need no more specific medication than NSAID-analgetics. However, older patients and those treated with immunosuppressive medication are at high risk of developing postherpetic neuralgy (PHN), and may need intensive treatment for severe pain. Unfortunately there is no specific method so far to prevent PHN. In the prevention of PHN some promising results have been gained with antiviral drugs, sympathetic blocks, corticosteroids, psychotropic and anticonvulsive drugs. The earlier any of these treatments is started in AHM, the better results. When PHN has developed, in most cases there is no effective treatment to be offered. In the Pain Clinic of Helsinki University Hospital antidepressive and neuroleptic drugs as well as transcutaneous neurostimulation have been used for PHN treatment.