Herpes zoster (or shingles), an infectious disease caused by reactivation of latent varicella-zoster virus (VZV) in the dorsal root or cranial nerve ganglia, typically manifests as unilateral acute pain accompanied by a vesicular rash. The acute pain and rash usually resolve within 2– 4 weeks without treatment. Postherpetic neuralgia, commonly defined as pain that lasts .3 months after the onse...

Botulinum toxin (BoNT) has been used as a treatment for excessive muscle stiffness, spasticity, and dystonia. BoNT for approximately 40 years, and has recently been used to treat various types of neuropathic pain. The mechanism by which BoNT acts on neuropathic pain involves inhibiting the release of inflammatory mediators and peripheral neurotransmitters from sensory nerves. Recent journals ha...

Herpes zoster, the latent descendent of the varicella zoster virus, commonly is seen in clinical practice. Healthcare providers must recognize and treat the virus to decrease the incidence of postherpetic neuralgic pain syndrome. Treatment with an antiviral medication regimen should be initiated rapidly for patients who have had lesions for up to 72 hours. Acyclovir has been the treatment of ch...

Herpes zoster (HZ; shingles) results from reactivation of varicella-zoster virus that has been dormant in the spinal and cranial sensory ganglia following primary infection with varicella (chickenpox), usually during childhood. In developed countries more than 95% of the adult population are seropositive for varicella-zoster virus and are therefore at risk of developing HZ. Reactivation can occ...