Hopp til hovedinnhold

Postherpetisk nevralgi

Sist revidert:
Sist revidert av:
Definisjon:
Persisterende eller nyoppstått smerte mer enn 3 måneder etter debut av akutt herpes zoster infeksjon
Forekomst:
Tilstanden opptrer hos mer enn 10% av dem som har gjennomgått herpes zoster
Symptomer:
Ofte en vedvarende, brennende smerte som følger utbredelsen av den opprinnelige infeksjonen
Funn:
Det er som regel ingen kliniske funn når utslettet har gått tilbake
Diagnostikk:
Ingen tilleggsundersøkelser er av verdi
Behandling:
Avhenger av intensiteten av plagene: smertestillende, lokalt capsaicin, antidepressiva, antiepileptika
  1. McElveen WA. Postherpetic neuralgia. Medscape, last updated Mar 06, 2018. emedicine.medscape.com  
  2. Saguil A, Kane S, Mercado M, Lauters R. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician. 2017 Nov 15;96(10):656-663. PMID: 29431387. PubMed  
  3. Johnson RW, Rice AS. Clinical practice. Postherpetic neuralgia. N Engl J Med. 2014 Oct 16;371(16):1526-33. doi: 10.1056/NEJMcp1403062 DOI  
  4. Forbes HJ, Thomas SL, Smeeth L, et al. A systematic review and meta-analysis of risk factors for postherpetic neuralgia. Pain. 2016;157(1):30-54. PMID: 26218719 PubMed  
  5. O'Connor KM, Paauw DS. Herpes zoster. Med Clin North Am. 2013;97(4):503–522, ix. PMID: 23809711. PubMed  
  6. Dworkin RH, Gnann JW Jr, Oaklander AL, et al. Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain 2008; 9:S37. PubMed  
  7. Pickering G, Leplege A. Herpes zoster pain, postherpetic neuralgia, and quality of life in the elderly. Pain Pract. 2011 Jul-Aug;11(4):397-402. Epub 2010 Dec 29. PMID: 21199312. PubMed  
  8. Navez ML, Monella C, Bösl I, Sommer D, Delorme C. 5% Lidocaine Medicated Plaster for the Treatment of Postherpetic Neuralgia: A Review of the Clinical Safety and Tolerability. Pain Ther. 2015 Jun;4(1):1-15. pmid: 25896574. PubMed  
  9. Slapø GD, Schjøtt J. Medikamentell behandling av nevropatisk smerte. Tidsskr Nor Legeforen 2013; 133: 971-3. Tidsskrift for Den norske legeforening  
  10. Liu X, Wei L, Zeng Q, et al. The Treatment of Topical Drugs for Postherpetic Neuralgia: A Network Meta-Analysis. Pain Physician 2020; 23: 541-51. PMID: 33185370 PubMed  
  11. Mou J, Paillard F, Turnbull B, et al. Qutenza (Capsaicin) 8% patch onset and duration of response and effects of multiple treatments in neuropathic pain patients. Clin J Pain 2013 Jun 11. PMID: 23765045. PubMed  
  12. Moore RA, Wiffen PJ, Derry S, Toelle T, Rice AS. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2014; 4: CD007938. doi:10.1002/14651858.CD007938.pub3 DOI  
  13. Sang CN, Sathyanarayana R, Sweeney M. Gastroretentive gabapentin (G-GR) formulation reduces intensity of pain associated with postherpetic neuralgia (PHN). Clin J Pain 2012, Jul 13. pmid:22801243. PubMed  
  14. Fan H, Yu W, Zhang Q, et al. Efficacy and safety of gabapentin 1800 mg treatment for post-herpetic neuralgia: a meta-analysis of randomized controlled trials. J Clin Pharm Ther. 2014;39(4):334-42. doi: 10.1111/jcpt.12167 DOI  
  15. Freynhagen R, Strojek K, Griesing T, Whalen E, Balkenohl M. Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens. Pain 2005; 115: 254-63. PubMed  
  16. Wiffen PJ, Derry S, Moore RA, et al. Antiepileptic drugs for neuropathic pain and fibromyalgia - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2013 ;11:CD010567. doi: 10.1002/14651858.CD010567.pub2 DOI  
  17. Zin CS, Nissen LM, Smith MT, et al. An update on the pharmacological management of post-herpetic neuralgia and painful diabetic neuropathy. CNS Drugs 2008; 22: 417-42. PubMed  
  18. McNicol ED, Midbari A, Eisenberg E. Opioids for neuropathic pain. Cochrane Database Syst Rev 2013; 8: CD006146. doi: 10.1002/14651858.CD006146.pub2 DOI  
  19. Apalla Z, Sotiriou E, Lallas A, et al. Botulinum toxin A in postherpetic neuralgia: A parallel, randomized, double-blind, single-dose, placebo-controlled trial. Clin J Pain 2013. pmid:23370074 PubMed  
  20. Wu CY, Lin HC, Chen SF, et al. Efficacy of Pulsed Radiofrequency in Herpetic Neuralgia: A Meta-Analysis of Randomized Controlled Trials. Clin J Pain. 2020 Nov;36(11):887-895. PMID: 32701526 PubMed  
  21. Kotani N, Kushikata T, Hashimoto H, et al. . Intrathecal methylprednisolone for intractable postherpetic neuralgia.. N Engl J Med 2000; 343: 1514-9. PubMed  
  22. Chen N, Li Q, Yang J, et al. Antiviral treatment for preventing postherpetic neuralgia. Cochrane Database Syst Rev. 2014;2:CD006866. PMID: 24500927 PubMed  
  23. Gagliardi AMZ, Andriolo BNG, Torloni MR, et al. Vaccines for preventing herpes zoster in older adults. Cochrane Database of Systematic Reviews 2019, Issue 11. The Cochrane Library  
  24. Johnson RW, Bouhassira D, Kassianos G, Leplège A, Schmader KE, Weinke T. The impact of herpes zoster and post-herpetic neuralgia on quality-of-life. BMC Med. 2010 Jun 21;8:37. doi: 10.1186/1741-7015-8-37. PMID: 20565946 PubMed  
  25. Massengill JS, Kittredge JL. Practical considerations in the pharmacological treatment of postherpetic neuralgia for the primary care provider. J Pain Res. 2014;7:125–132. PMID: 24648752. PubMed  
  • Dr. Stephan Schüler, avdelingsoverlege Nevrologisk avdeling, Sykehuset Namsos
  • Terje Johannessen, professor i allmennmedisin, Trondheim