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Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up.

Abstract

OBJECTIVE
To estimate the frequency, duration, and clinical importance of postherpetic neuralgia after a single episode of herpes zoster.
DESIGN
Prospective cohort study with long term follow up.
SETTING
Primary health care in Iceland.
PARTICIPANTS
421 patients with a single episode of herpes zoster.
MAIN OUTCOME MEASURES
Age and sex distribution of patients with herpes zoster, point prevalence of postherpetic neuralgia, and severity of pain at 1, 3, 6, and 12 months and up to 7.6 years after the outbreak of zoster.
RESULTS
Among patients younger than 60 years, the risk of postherpetic neuralgia three months after the start of the zoster rash was 1.8% (95% confidence interval 0.59% to 4.18%) and pain was mild in all cases. In patients 60 years and older, the risk of postherpetic neuralgia increased but the pain was usually mild or moderate. After three months severe pain was recorded in two patients older than 60 years (1.7%, 2.14% to 6.15%). After 12 months no patient reported severe pain and 14 patients (3.3%) had mild or moderate pain. Seven of these became pain free within two to seven years, and five reported mild pain and one moderate pain after 7.6 years of follow up. Sex was not a predictor of postherpetic neuralgia. Possible immunomodulating comorbidity (such as malignancy, systemic steroid use, diabetes) was present in 17 patients.
CONCLUSIONS
The probability of longstanding pain of clinical importance after herpes zoster is low in an unselected population of primary care patients essentially untreated with antiviral drugs.

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  • Authors

    Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA

    Source

    BMJ (Clinical research ed.) 321:7264 2000 Sep 30 pg 794-6

    MeSH

    Adolescent
    Adult
    Age Distribution
    Aged
    Antiviral Agents
    Child
    Child, Preschool
    Female
    Follow-Up Studies
    Herpes Zoster
    Humans
    Iceland
    Infant
    Male
    Middle Aged
    Neuralgia
    Prevalence
    Prospective Studies
    Recurrence
    Sex Distribution

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11009518