Goßrau G
UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland,
Nervenarzt. 2015 Feb;86(2):219-28; quiz 229-30. doi: 10.1007/s00115-014-4233-1.
Postherpetic neuralgia is considered to be a neuropathic pain syndrome. Typically, patients experience pain in the dermatomes of skin lesions persisting for more than 3 months after skin restitution. About 10% of patients with herpes zoster develop postherpetic neuralgia. Its prevalence increases with age. Common clinical symptoms include continuous burning pain, sharp pain attacks, and allodynia. Additionally, sensory hyperactivation or loss in the affected skin area is present. Pathophysiology includes mechanisms of peripheral and central sensitization, based on damaged nerve fibers as the main mechanisms for pain generation and its maintenance. Clinical studies did show pain relief in postherpetic neuralgia after administration of antidepressants, antiepileptic drugs, opioids, and topical capsaicin and lidocaine. Nevertheless, about one third of patients do not respond to conventional treatment. Given the fact that postherpetic neuralgia is considered to be a chronic pain disease, a multidisciplinary treatment approach is necessary.
带状疱疹后神经痛被认为是一种神经性疼痛综合征。通常，患者在皮肤损伤愈合后，在皮损的皮节区域仍会持续疼痛超过3个月。约10%的带状疱疹患者会发生带状疱疹后神经痛。其患病率随年龄增长而增加。常见的临床症状包括持续性灼痛、刺痛发作和痛觉过敏。此外，受累皮肤区域还存在感觉过敏或感觉丧失。病理生理学包括外周和中枢敏化机制，受损神经纤维是疼痛产生及其维持的主要机制。临床研究确实表明，给予抗抑郁药、抗癫痫药、阿片类药物以及局部辣椒素和利多卡因后，带状疱疹后神经痛患者的疼痛有所缓解。然而，约三分之一的患者对传统治疗无反应。鉴于带状疱疹后神经痛被认为是一种慢性疼痛疾病，多学科治疗方法是必要的。
