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Review
. 2017:2017:1681765.
doi: 10.1155/2017/1681765. Epub 2017 Dec 5.

Postherpetic Neuralgia and Trigeminal Neuralgia

L Feller  1 , R A G Khammissa  1 , J Fourie  1 , M Bouckaert  2 , J Lemmer  1
Affiliations
Review

Postherpetic Neuralgia and Trigeminal Neuralgia

L Feller et al. Pain Res Treat. 2017.

Abstract

Postherpetic neuralgia (PHN) is an unpredictable complication of varicella zoster virus- (VZV-) induced herpes zoster (HZ) which often occurs in elderly and immunocompromised persons and which can induce psychosocial dysfunction and can negatively impact on quality of life. Preventive options for PHN include vaccination of high-risk persons against HZ, early use of antiviral agents, and robust management of pain during the early stage of acute herpes zoster. If it does occur, PHN may persist for months or even years after resolution of the HZ mucocutaneous eruptions, and treatment is often only partially effective. Classical trigeminal neuralgia is a severe orofacial neuropathic pain condition characterized by unilateral, brief but recurrent, lancinating paroxysmal pain confined to the distribution of one or more of the branches of the trigeminal nerve. It may be idiopathic or causally associated with vascular compression of the trigeminal nerve root. The anticonvulsive agents, carbamazepine or oxcarbazepine, constitute the first-line treatment. Microvascular decompression or ablative procedures should be considered when pharmacotherapy is ineffective or intolerable. The aim of this short review is briefly to discuss the etiopathogenesis, clinical features, and treatment of PHN and classical trigeminal neuralgia.

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Figures

Figure 1
Figure 1
Orofacial neuralgic pain conditions that can occur in the somatosensory distribution of the trigeminal nerve. Careful examination, a thorough medical and dental history, and neuroimaging of the head with magnetic resonance imaging (MRI) are necessary for the diagnosis of classical and symptomatic trigeminal neuralgia [18, 24].
Box 1
Box 1
Diagnostic criteria for classical trigeminal neuralgia. Adapted from [, –24, 26, 27].
See this image and copyright information in PMC

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