Postherpetic neuralgia

  It has been proposed to define postherpetic neuralgia (PHN) as persistent pain for more than 1 month after clinical cure of acute herpes zoster. The main cause of postherpetic neuralgia is the destruction of the thick outer skin fibers of the nerve fibers by massive herpes virus ingestion resulting in abnormal nerve discharges, followed by the residual virus acting irregularly. Post-herpetic neuralgia is one of the most serious pains in the middle-aged and elderly population, and if it does not receive timely and effective treatment, the duration of pain can be as short as 1-2 years or as long as 3 years, and the longest duration of the disease in individual patients can even exceed 10 years. Patients suffer from severe pain for a long time, which not only seriously reduces their quality of life and loss of work and social skills, but also increases the medical expenses year by year, bringing a heavy burden to the family and society.  Generally speaking, people with low immunity are prone to neuralgia after herpes zoster. There are many reasons that affect the body’s own immunity, and young people who are in a state of chronic fatigue or who have recently had acute or chronic infectious diseases such as the flu or infectious hepatitis can lead to low immunity. Older patients with reduced cardiopulmonary function, a history of traumatic fractures or tumors, parallel radiotherapy, long-term application of immunosuppressants, etc. tend to severely reduce the body’s resistance and have a high probability of remaining neuralgia once a herpes attack occurs.  In general, the incidence of post-acute herpes zoster neuralgia is proportional to age, and foreign literature reports that the incidence of patients with shingles having PHN is 4% for 10-19 year olds, 2% for 20-29 year olds, 15% for 30-39 year olds, 33% for 40-49 year olds, 49% for 50-59 year olds, 65% for 60-69 year olds, and 74% for 70-79 year olds; while pain duration More than 1 year was found in 4-10% of patients in the 10-49 years group, 18-48% in the 50-79 years group, and up to 10 years or more in individual patients. The prevalence and proportion of postherpetic neuralgia are 15% for the head and face, 12% for the neck and collar, 55% for the chest and back, 14% for the lumbar abdomen, 3% for the sacrococcygeal region, and about 1% for the generalized region. The patients with PHN we encountered in our clinical work were mostly in the thoracic back!