Articles: neuralgia.
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After remission of the dermatological symptoms of herpes zoster infection, post-zoster neuralgia (PZN) can persist or recur for months and years. Most frequently, satisfactory therapy of PZN is not possible. During recent years the persistence of viruses on the surface of neuronal cells has been discussed as the possible reason for chronic pain. ⋯ Treating pain in persistent PZN is extremely difficult and mostly results in a small diminution of the pain level. Persistence of viruses on the neuronal cell surface and resulting reduction of "luxury functions" of those cells may explain algogenesis by PZN and resistance to therapeutic efforts. We used VZI for the first time for therapy of PZN and observed a striking analgesic effect in all patients for the entire surveillance time.
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We present four patients complaining of neuralgic pains across the nasal bridge following trauma, who were successfully treated by division of the external nasal nerve. We believe it is a useful treatment in selected cases.
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Postherpetic neuralgia (PHN) is the most common and feared complication of herpes zoster. The more severe and painful the initial zoster outbreak, the more likely that PHN will develop, with elderly patients being at greatest risk. ⋯ Tricyclic antidepressants are the mainstay of treatment for established PHN, aided by transcutaneous electrical nerve stimulation, physical therapy techniques, and cautious use of other medications. Topical agents, such as capsaicin, aspirin, and lidocaine, may soon become one of the mainstays of therapy for PHN.