Natural History of Pain Following Herpes Zoster

Overview

Journal Pain

Specialties Neurology
Psychiatry

Date 2006 Oct 31

PMID 17070998

Citations 19

Authors

Hans Gustav Thyregod

Michael C Rowbotham

Michelle Peters

Jessica Possehn

Marlene Berro

Karin Lottrup Petersen

Affiliations

Soon will be listed here.

Abstract

In a longitudinal observational study of 94 patients (39 M:55 F, mean age 69) at elevated risk for developing post herpetic neuralgia (PHN), the natural history of pain during the first 6 months after herpes zoster (HZ) rash onset was determined. Pain severity and impact were rated using pain-VAS, SF-MPQ, and MPI. Applying a definition of PHN of average daily pain >0/100 on the pain VAS during the last 48 h, 30 subjects had PHN at 6 months. These 30 subjects reported more pain and a higher SF-MPQ score (p<0.01) at study inclusion than the 64 subjects whose pain completely resolved by 6 months. At 6 months, mean daily pain in the PHN group was 11/100 (95% CI 5,16) and only nine of these subjects were still taking prescription medication for HZ pain. The rate of recovery (pain severity over time) was the same in the PHN and no-pain groups. At study inclusion, the SF-MPQ and MPI scores in our PHN group were similar to historical controls with chronic severe PHN enrolled in clinical trials, but by 6 months the scores in our PHN subjects were significantly lower than historic controls. Only two subjects met the more stringent criteria for 'clinically meaningful' PHN at 6 months (> or = 30/100 on the pain VAS). Defining PHN as average daily pain >0/100 at 6 months after rash onset appears to substantially overestimate the number of HZ patients negatively impacted by ongoing pain and disability.

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References

Haanpaa M, Laippala P, Nurmikko T . Allodynia and pinprick hypesthesia in acute herpes zoster, and the development of postherpetic neuralgia. J Pain Symptom Manage. 2000; 20(1):50-8. DOI: 10.1016/s0885-3924(00)00149-4. View

Helgason S, Petursson G, Gudmundsson S, Sigurdsson J . Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. BMJ. 2000; 321(7264):794-6. PMC: 27491. DOI: 10.1136/bmj.321.7264.794. View

Johnson R . Herpes zoster--predicting and minimizing the impact of post-herpetic neuralgia. J Antimicrob Chemother. 2001; 47 Suppl T1:1-8. DOI: 10.1093/jac/47.suppl_1.1. View

Rowbotham M, Petersen K . Zoster-associated pain and neural dysfunction. Pain. 2001; 93(1):1-5. DOI: 10.1016/S0304-3959(01)00328-1. View

Arani R, Soong S, Weiss H, Wood M, Fiddian P, Gnann J . Phase specific analysis of herpes zoster associated pain data: a new statistical approach. Stat Med. 2001; 20(16):2429-39. DOI: 10.1002/sim.851. View

Nagasako E, Johnson R, Griffin D, Dworkin R . Rash severity in herpes zoster: correlates and relationship to postherpetic neuralgia. J Am Acad Dermatol. 2002; 46(6):834-9. DOI: 10.1067/mjd.2002.120924. View

Desmond R, Weiss H, Arani R, Soong S, Wood M, Fiddian P . Clinical applications for change-point analysis of herpes zoster pain. J Pain Symptom Manage. 2002; 23(6):510-6. DOI: 10.1016/s0885-3924(02)00393-7. View

Wood M . Understanding pain in herpes zoster: an essential for optimizing treatment. J Infect Dis. 2002; 186 Suppl 1:S78-82. DOI: 10.1086/342958. View

Raja S, Haythornthwaite J, Pappagallo M, Clark M, Travison T, Sabeen S . Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology. 2002; 59(7):1015-21. DOI: 10.1212/wnl.59.7.1015. View

10.

Rowbotham M, Twilling L, Davies P, Reisner L, Taylor K, Mohr D . Oral opioid therapy for chronic peripheral and central neuropathic pain. N Engl J Med. 2003; 348(13):1223-32. DOI: 10.1056/NEJMoa021420. View

11.

Haythornthwaite J, Clark M, Pappagallo M, Raja S . Pain coping strategies play a role in the persistence of pain in post-herpetic neuralgia. Pain. 2003; 106(3):453-460. DOI: 10.1016/j.pain.2003.09.009. View

12.

Jung B, Johnson R, Griffin D, Dworkin R . Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology. 2004; 62(9):1545-51. DOI: 10.1212/01.wnl.0000123261.00004.29. View

13.

Berry J, Rowbotham M, Petersen K . Complex regional pain syndrome-like symptoms during herpes zoster. Pain. 2004; 110(1-2):e1-12. DOI: 10.1016/j.pain.2003.12.038. View

14.

Coplan P, Schmader K, Nikas A, Chan I, Choo P, Levin M . Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory. J Pain. 2004; 5(6):344-56. DOI: 10.1016/j.jpain.2004.06.001. View

15.

Hope-Simpson R . Postherpetic neuralgia. J R Coll Gen Pract. 1975; 25(157):571-5. PMC: 2157719. View

16.

Kerns R, Turk D, Rudy T . The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain. 1985; 23(4):345-356. DOI: 10.1016/0304-3959(85)90004-1. View

17.

Melzack R . The short-form McGill Pain Questionnaire. Pain. 1987; 30(2):191-197. DOI: 10.1016/0304-3959(87)91074-8. View

18.

McKendrick M, McGill J, Wood M . Lack of effect of acyclovir on postherpetic neuralgia. BMJ. 1989; 298(6671):431. PMC: 1835689. DOI: 10.1136/bmj.298.6671.431. View

19.

Nurmikko T, Bowsher D . Somatosensory findings in postherpetic neuralgia. J Neurol Neurosurg Psychiatry. 1990; 53(2):135-41. PMC: 487954. DOI: 10.1136/jnnp.53.2.135. View

20.

Cohen S, Tyrrell D, Smith A . Psychological stress and susceptibility to the common cold. N Engl J Med. 1991; 325(9):606-12. DOI: 10.1056/NEJM199108293250903. View