• Dianna Quan, Barbara N Hammack, John Kittelson, and Donald H Gilden.
• Department of Neurology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
• Arch Neurol Chicago. 2006 Jul 1;63(7):940-2.

BackgroundPostherpetic neuralgia (PHN) is a complication of shingles (herpes zoster), a painful rash due to varicella-zoster virus reactivation. Studies of patients with PHN and zoster sine herpete (radicular pain without rash) support the notion that low-grade viral ganglionitis contributes to pain. If chronic pain reflects active infection, then antiviral therapy may help patients with PHN.ObjectiveTo determine whether antiviral treatment helps reduce PHN-associated pain.DesignProspective, open-label phase I/II clinical trial.SettingTertiary care university hospital.PatientsFifteen patients with moderate to severe PHN.InterventionsIntravenous acyclovir at a dosage of 10 mg/kg every 8 hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times per day for 1 month.Main Outcome MeasureNumeric Rating Scale for Pain score.ResultsAs defined by a decrease of 2 or more points on the Numeric Rating Scale for Pain, 8 (53%) of 15 patients reported improvement.ConclusionClinical improvement reported by most of our patients warrants further investigation in a larger, randomized, double-blind, placebo-controlled trial.

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