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PRE-HERPETIC NEURALGIA-TERMINOLOGY
O P Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai,
Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Most of the text books talk about post herpetic neuralgia. In my experience most of the patients of Herpes Zoster develop a rash after 2-3 days. During this pre-rash period they experience severe pain in the root area of the trunk or abdomen (or elsewhere), which is often misdiagnosed as unstable angina, pericarditis, pleurisy, renal and biliary colic disease. The diagnosis should be thought of by the "severity" of the pain. The pain is so severe and superficial that the patient dislikes your touching the skin over that area. In my opinion, this should be called as "pre-herpetic neuralgia". This neuralgia occurs in every patient of Herpes Zoster before the rash appears.While the symptom of post herpetic neuralgia is a complication of Herpes Zoster, this complication can be minimised if :
- The children have been immunised against chicken pox.
- The patients are administered Acyclovir in a dose of 800 mg five times a day as early as possible.
- The patients are also given amitriptyline in the dose of 25 mg daily for a period of three months.
Till now there is no specific treatment for "Pre-herpetic neuralgia".
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