Postherpetic neuralgia

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Symptoms

By Mayo Clinic staff

The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on just one side of your body.

Signs and symptoms may include:

  • Pain. The pain associated with postherpetic neuralgia most commonly has been described as burning, sharp and jabbing, or deep and aching.
  • Sensitivity to light touch. People who have postherpetic neuralgia often cannot bear even the touch of clothing on the affected skin, a condition called allodynia.
  • Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.
  • Weakness or paralysis. In rare cases, you might also experience muscle weakness or paralysis if the nerves involved also control muscle movement.

When to see a doctor
See a doctor at the first sign of shingles. Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is cut in half if you begin taking antiviral medications within 72 hours of developing the shingles rash. While steroids are sometimes prescribed for a more rapid resolution of the shingles rash and to provide short-term pain relief, their role in preventing postherpetic neuralgia has not been proved.

References
  1. Treatment of postherpetic neuralgia. American Academy of Neurology. http://www.aan.com/professionals/practice/pdfs/pn_guideline_patients.pdf. Accessed July 3, 2012.
  2. Bajwa ZH, et al. Postherpetic neuralgia. http://www.uptodate.com/home/index.html. Accessed July 3, 2012.
  3. Watson P. Postherpetic neuralgia. American Family Physician. 2011;84:690.
  4. Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed July 3, 2012.
  5. Ultram (tramadol hydrochloride), Ultracet (tramadol hydrochloride/acetaminophen): Label change. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213264.htm. Accessed July 3, 2012.
  6. Watson JC (expert opinion). Mayo Clinic, Rochester, Minn. July 17, 2012.
  7. Irving GA, et al. NGX-4010, a capsaicin 8% dermal patch, administered alone or in combination with systemic neuropathic pain medications, reduces pain in patients with postherpetic neuralgia. Clinical Journal of Pain. 2012;28:101.
  8. Centers for Disease Control and Prevention, et al. Update on herpes zoster vaccine: Licensure for persons aged 50 through 59 years. MMWR. 2011;60:44. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a5.htm?s_cid=mm6044a5_w. Accessed July 18, 2012.
DS00277 Nov. 13, 2012

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