herpes simplex neuralgia

Areas in which a post herpes simplex neuralgia might occur.  Does it ever cause a diffuse neuralgia?


This discussion is related to Can Herpes Simplex cause postherpetic neuralgia?.

[DrNoopurMD]

Hi,

Thanks for posting.
Post herpetic neuralgia can occur in the chest or abdomen depending upon which dermatome is involved. It can occur in the eye, face and ear also.
http://en.wikipedia.org/wiki/Shingles
Hope this helps!

[kasbb86]

I am a 54 yr old male, in pretty good shape, non-smoker, non-drinker.  For the past 2 years I have experienced pain in the left side of my chest with tingling in the left arm.  I've seen 2 cardiologists and had a complete exam including an angiogram, showing no heart disease.  Since then I've seen gastroenterologists, pulmonologists, and pain specialists.  
My new doctor suggested PHN and tested me for the virus anitbody, which I have.  But I have never had any outbreak of shingles on the skin.  I've been on 300 mg of Gabapentin for 3 weeks now, and am using Capcaicin, but still have pain.  It feels like it's getting progressively worse.
I'm not so sure about my Doctor's diagnosis.  How can I know for certain?
How long does Gabapentin need to take effect?  
Would  a nerve block positively confirm the PNH diagnosis?
Any other tests to confirm this diagnosis?
Thank you.

[superthriftmom]

I believe I am suffering from postherpetic neuralgia caused by herpes simplex...I did not display all of the the 'normal' symptoms of shingles and do test positive for HSV1 and have recently been under a lot of mental and physical stress.  My first episode resembled all of the symtoms (symptoms) for encephalitis which took several weeks to subside but is now followed by a subsequent episode...I called and requested an antiviral which seemed to help in the begining, but now the pain, achy, stiff neck, creaping pain and hot patchy feeling is coming back.  What tests do you recommend to precisely diagnose my problem and what course of action can be taken?  Primary symptoms is a sharp yet dull pain in my spinal cord with systemic heat like pain radiating through my neck, arms, chest...stiff neck and head, and swollen lymph nodes in the neck and occassional in the submadular gland...all of my symptoms are chest level and higher.  Can you give me any advice?

[aeiou1]

Up to 70% of genital HSV infections are clinically unrecognized. The majority of patients with genital herpes have symptoms and signs unrecognized either by themselves or their clinicians. A recent retrospective study on clinical presentation of the disease reported 51% of cases to be atypical (11)  http://www.ncbi.nlm.nih.gov/pubmed/11385226. Currently, many doctors rely on the typical clinical presentation of the disease. Underdiagnosis of genital herpes because of misinterpretation of either anatomical or morphological presentations of the disease can accelerate the spread of the epidemic.

What all that means is that your doctors think they know herpes, but they DON'T, and more than half of cases in the aforementioned study did not appear according to the conventional "wisdom" taught in medical schools.  BE AWARE that most doctors are not current on the literature. HERPES CAUSES NEUROPATHIES in many people affected. If they tell you only varicella does that, they are wrong.  If they tell you HSV 1 or HSV 2 are not associated with neuralgia, they are wrong.  If you're putting 2 and 2 together, and you think your herpes is causing your back and leg pain and sensitivity, IT PROBABLY IS.  Keep looking for a doctor who is current on the literature and understands the neurolopathic aspect of the disease.  Ask before making an appointment so you don't keep wasting your money.  There is no good news here.  There is no cure, and opiods are virtually useless for MOST neuropathies, not just herpes. The medication Neurontin (gabapentin) may be helpful. Get plenty of rest, drink lots of water, and eat well.  Support your immune system as much as possible. And EDUCATE YOUR DOCTORS.  If they're not suffering, they're not likely to just spontaneously look into it.