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Risk factors identified for persistent post-shingles pain

ST. PAUL, Minn. Researchers have recently confirmed a set of indicators that, alone and in combination, identify shingles patients who have an increased risk of developing persistent pain after the shingles rash heals. Results and implications of their study will be presented in the May 11 issue of Neurology, the scientific journal of the American Academy of Neurology.

Shingles (herpes zoster) has the highest incidence of all neurological diseases, affecting approximately half a million Americans annually. If one lives to age 85, the chance of shingles occurring is nearly 50 percent. Shingles is a reactivation of the virus responsible for chicken pox, characterized by a rash confined to one side of the body and accompanied by moderate to severe acute pain in the majority of patients. Pain that persists at least 120 days beyond the onset of shingles rash has been termed postherpetic neuralgia (PHN). PHN occurs in approximately 20 to 25 percent of shingles patients.

Until recently, older age was the only known risk factor that identified which patients with shingles were more likely to develop the chronic pain of PHN. Previous studies have identified a myriad of indicators as potential risk factors for PHN, though they did not control for the distinction between what current researchers have defined as the three phases of shingles pain acute pain within 30 days of rash onset, subacute pain that persists beyond the acute phase but resolves before the diagnosis of PHN can be made, and PHN that persists more than 120 days after rash onset.

"Our objectives were to identify risk factors for PHN, to determine the combinations of risk factors that identify high risk patients and to examine the characteristics of patients with subacute herpetic neuralgia, that is, pain that persists beyond the acute phase but resolves before a diagnosis of PHN can be made," stated study author Robert H. Dworkin, PhD, of the University of Rochester School of Medicine
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Contact: Kathy Stone
kstone@aan.com
651-695-2763
American Academy of Neurology
10-May-2004


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