Michael C. Rowbotham, MD California Pacific Medical Center Research Institute Department of Anesthesia, UCSF School of Medicine San Francisco, Calif., USA Email: [email protected] P ostherpetic neuralgia (PHN) is t e most frequent chronic complication of herpes zoster ( hingles). Herpes zoster (HZ) represents a reactivation of the varicella zo ter vi us (VZV), a ubiquitous, highly neurotropic,...

A 74-year-old white man presented with unilateral radicular pain extending across the left side of his chest and back. A diagnosis of postherpetic neuralgia, a sequela of herpes zoster, was made. Herpes zoster represents a reactivation of the varicella zoster virus that lies dormant in patients with past chickenpox. Risk factors for the disease include advanced age, stress, immunodeficiency, an...

OBJECTIVES The history behind the current understanding of the varicella-zoster virus and its relationship to the pain conditions caused by shingles and postherpetic neuralgia are reviewed. The framework for the current conceptualization is Hope-Simpson's latency hypothesis. Data from recent work in virology, neuroanatomy and epidemiology are reviewed, as is work using varicella-zoster virus-in...

Although postherpetic neuralgia (PHN) is a common chronic pain syndrome, the pathophysiology of this disorder is not well known and management is often very difficult. N-Methyl-D-Aspartate (NMDA) receptor antagonists are known to be effective in PHN, and magnesium, a physiological blocker of NMDA receptors, is widely used to treat various chronic pain disorders. Here, we present a case of the P...

Postherpetic neuralgia (PHN) is a severe neuropathic pain syndrome. The treatment of PHN is complex and refractory in some patients. We present two cases with refractory anterior abdominal wall pain due to PHN that were successfully treated with transversus abdominis plane (TAP) block. The TAP block seems to be an alternative for patients with PHN who suffer from anterior abdominal wall pain ac...