POSTHERPETIC NEURALGIA - THE IMPORTANCE OF PREVENTING THIS INTRACTABLE END-STAGE DISORDER

An argument is presented here for postherpetic neuralgia as an intract able end-stage disorder for many patients. The exciting possibility of prevention of this disorder by early, aggressive treatment exists; ho wever, the extent to which therapy can be effective is unknown. Early, aggressive treatment of the pain of herpes tester is, nevertheless, u rged, and the options for treatment are discussed. These options inclu de antiviral therapy within the first 72 h, if possible, from the onse t of rash or radicular pain and the use of analgesics, including opioi ds (if necessary), nerve blocks, and early antidepressant therapy. In addition, the extent to which vaccination of older adults will prevent postherpetic neuralgia is unknown but appears to hold promise.