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What is Post-Herpetic Neuralgia?

After the initial Chicken Pox infection by the Varicella Zoster Virus (VZV), the virus implants itself in the neural ganglia. Herpes Zoster flares up when the dormant VZV is reactivated, usually due to cell-mediated immune deficiency.

While Herpes Zoster flares may subside without further issue, Post-Herpetic Neuralgia (PHN) is one of the complications of severe VZV infection.

While it is understood that early intervention (with 3 days) with anti-viral medicine can prevent PHN,  There are many people who take the risk to assume that once past the active blister phase, everything would be ok. This is not true.

Two Cases of Post-Herpetic Neuralgia:

Two recent cases I saw show that we really don’t know if we will get Post-Herpetic Neuralgia. In both case, the patients were males of Asian descent in their 40s. Both had begun with antiviral medication upon receiving diagnosis.

Case #1: No Problem!

The first person presented with lesions around the right sacrum, with pain radiating all the way to the posterior anus. He was in pain!

We confirmed that it was not genital herpes, which may also affect the area around the anus.

Electroacupuncture was administered only once and he felt better after that first and only treatment, deciding not to proceed with subsequent sessions. He also declined the use of herbs. One week later, he reported feeling fine and did not seem perturbed any more by his condition.

Case #2: Big Problem!

The second person had lesions on his right face which had already subsided. He had no more blisters, but was coming for PHN in the areas mapped by the trigeminal nerve, which includes the area around the eyes, the cheek and the mouth/chin.

By the time he had decided to come in for acupuncture, he had already finished his course of antivirals. Despite being past the active blister phase, there was remaining PHN. I told him it would have been better had he come in in the beginning, but hind sight is 20/20.

In the end, he had to come in for acupuncture every day or every other day to keep the pain manageable — acupuncture definitely helps, whether during the active blister phase or for PHN. I also gave him Chinese herbs which were instrumental in bringing about full recovery.

What are the odds?

These two examples serve to show that there is a risk NOT to get acupuncture/herbal treatment earlier. This is especially true for Herpes Zoster in the face or affecting the eyes.

The first patient was did fine with just one acupuncture session, but the second patient would have done better had he come earlier for treatment.

References:

Y. Hua, Y. Li, Q. Guo, Ll Ji, J.B. Wang. Observation on clinical effect of electroacupuncture plus pricking-cupping bloodletting therapy for herpes zoster. J Acupunct Tuina Sci, 13 (2015), pp. 54-57.
X. Fang. Clinical observation of acupuncture therapy for postherpetic neuralgia. J Acupunct Tuina Sci, 9 (2011), pp. 113-115.
S. Yuan-Zheng, M. Jin-Yun.Treatment of 28 cases of post-herpetic neuralgia by local encirled needling method. J Acupunct Tuina Sci, 4 (2006), pp. 250-251.

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