Expert review of neurotherapeutics
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Expert Rev Neurother · Nov 2007
ReviewPostherpetic neuralgia: epidemiology, pathophysiology and management.
Postherpetic neuralgia (PHN) is a neuropathic pain syndrome and is the most common complication of herpes zoster (HZ; shingles). PHN occurs mainly in HZ patients 60 years of age and older, in particular in those suffering from more severe acute pain and rash. Administration of antiviral drugs reduces the duration of pain associated with HZ. ⋯ Mechanism-based therapy is a desirable goal but so far proves elusive. The incidence of HZ, and therefore that of PHN, is likely to increase as a result of greater longevity and increasing numbers of patients receiving treatment that compromises cell-mediated immunity. A zoster vaccine for administration to adults reduces the incidence of HZ and PHN, as well as the burden of illness associated with these conditions.
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Expert Rev Neurother · Nov 2007
ReviewVoltage-gated sodium channel blockers for the treatment of neuropathic pain.
Pain serves a crucial physiological function, warning the body of impending or actual tissue damage, preventing further damage and aiding the healing process. Neuropathic pain, resulting from nervous system injury or dysfunction, can be a serious medical problem and especially difficult to treat. Although sodium channel blockers are clinically useful for treating pain, they often provide only partial relief and adverse effects associated with nonspecific actions can limit their use. Research on the roles of sodium channels in neuronal excitability and pain shows that specific sodium channel isoforms are crucial determinants of nociception and neuropathic pain, indicating that it should be possible to develop sodium channel blockers with lower toxicity and enhanced efficacy for treating neuropathic pain.