Post-herpetic neuralgia: diagnosis and therapy. A clinical situation that is the synthesis of all types of neuropathic pain

Post-herpetic neuralgia (PHN) is of particular interest to the algologist because it can be produced by all the pathogenetic mechanisms of neuropathic pain, singly or variously associated. PHN is caused by reactivation in the spinal or cranial ganglia of the varicella virus, which initiates differen...

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Bibliographic Details
Main Author: Guido Orlandini, MD
Format: Article
Language:English
Published: Publiediting 2024-06-01
Series:Pathos
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Online Access:https://www.pathos-journal.com/2024_1_246.html
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Summary:Post-herpetic neuralgia (PHN) is of particular interest to the algologist because it can be produced by all the pathogenetic mechanisms of neuropathic pain, singly or variously associated. PHN is caused by reactivation in the spinal or cranial ganglia of the varicella virus, which initiates different pathogenetic mechanisms depending on the nerve site reached: in the ganglion it involves cell body damage and deafferentation of the 2nd neuron (deafferentation PHN or type III), migrating to the skin it causes peripheral nerve damage with nerve fiber disruption (axonal neuropathy PHN or type II A) and/or demyelination of Aα, Aβ and Aδ fibers (demyelination PHN or type II B) as well as nociceptor damage (persistent nociceptor hyperexcitability PHN or type I). Finally, centripetal migration of virus towards the neuraxis results in damage to the dorsal root (Type III PHN) and central neurons (central PHN or type IV).
ISSN:2385-0744