Management of postherpetic neuralgia

Postherpetic neuralgia is a perplexing disorder in which pain develops as a result of herpes zoster. It is a common cause of neuropathic pain and may render its effects especially on the elderly and immunocompromised. Once established, postherpetic neuralgia is resistant to most treatment modalities and can lead to much despair. Many therapeutic approaches have been attempted through the years, most with varying results. This review describes clinical manifestations including allodynia, hyperaesthesia and anaesthesia. It also reviews pharmacologic and non-pharmacologic treatment modalities including a review of anaesthetic nerve blocks, neurostimulation, acupuncture and surgical techniques.