TREATMENT OF POSTHERPETIC NEURALGIA

Detalhes bibliográficos
Autor(a) principal: Teotónio, Rute
Data de Publicação: 2013
Outros Autores: Brinca, Ana, Cardoso, José Carlos, Rodrigues, Bruno
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.29021/spdv.70.4.98
Resumo: Postherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. 
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spelling TREATMENT OF POSTHERPETIC NEURALGIATRATAMENTO DA NEVRALGIA PÓS-HERPÉTICAPostherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. A Nevralgia Pós-Herpética (NPH) é uma complicação frequente da infecção por herpes zoster, espe- cialmente em doentes idosos. Por ser uma patologia complexa e de difícil controlo, peritos têm-se reunido com o propósito de estabelecer guidelines de tratamento farmacológico da NPH. Recentemente a European Federation of Neurological Societies (EFNS) juntou um desses grupos com este mesmo objectivo. Neste trabalho, os autores pre- tendem fazer uma revisão e actualização do tema, discutindo o papel de fármacos, nomeadamente os antivirais, antidepressivos tricíclicos, alguns anticonvulsivantes (gabapentina e pregabalina) e a lidocaína tópica, cuja eficácia terapêutica na NPH está bem estabelecida. A importância dos opióides e da capsaicina é também objecto de reflexão, bem como de algumas terapêuticas recentemente apontadas como possíveis alternativas. Dentro destas destacamos a estimulação eléctrica transcutânea nervosa (TNS), a toxina botulínica e os inibidores do factor de necrose tumoral alfa. É largamente reconhecido que o controlo da dor na NPH revela-se frequentemente um desafio, exigindo um frágil equilíbrio entre a eficácia terapêutica e os efeitos secundários muitas vezes sentidos por uma população que, na maioria das vezes, é idosa, encontra-se sob politerapia e apresenta múltiplas comorbilidades. PALAVRAS-CHAVE – Nevralgia Pós-Herpética; Guideline; Tratamento farmacológico. Sociedade Portuguesa de Dermatologia e Venereologia2013-04-20T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.70.4.98oai:ojs.revista.spdv.com.pt:article/98Journal of the Portuguese Society of Dermatology and Venereology; Vol 70 No 4 (2012): Outubro-Dezembro; 451-457Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 70 n. 4 (2012): Outubro-Dezembro; 451-4572182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/98https://doi.org/10.29021/spdv.70.4.98https://revista.spdv.com.pt/index.php/spdv/article/view/98/99Teotónio, RuteBrinca, AnaCardoso, José CarlosRodrigues, Brunoinfo:eu-repo/semantics/openAccess2022-10-06T12:34:40Zoai:ojs.revista.spdv.com.pt:article/98Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:10:41.312356Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv TREATMENT OF POSTHERPETIC NEURALGIA
TRATAMENTO DA NEVRALGIA PÓS-HERPÉTICA
title TREATMENT OF POSTHERPETIC NEURALGIA
spellingShingle TREATMENT OF POSTHERPETIC NEURALGIA
Teotónio, Rute
title_short TREATMENT OF POSTHERPETIC NEURALGIA
title_full TREATMENT OF POSTHERPETIC NEURALGIA
title_fullStr TREATMENT OF POSTHERPETIC NEURALGIA
title_full_unstemmed TREATMENT OF POSTHERPETIC NEURALGIA
title_sort TREATMENT OF POSTHERPETIC NEURALGIA
author Teotónio, Rute
author_facet Teotónio, Rute
Brinca, Ana
Cardoso, José Carlos
Rodrigues, Bruno
author_role author
author2 Brinca, Ana
Cardoso, José Carlos
Rodrigues, Bruno
author2_role author
author
author
dc.contributor.author.fl_str_mv Teotónio, Rute
Brinca, Ana
Cardoso, José Carlos
Rodrigues, Bruno
description Postherpetic Neuralgia (PHN) is a common complication of acute Herpes Zoster, particularly in elderly pa- tients. Being a complex disorder of difficult control, experts have been trying to establish guidelines for pharmacological treatment of PHN. Recently, the European Federation of Neurological Societies (EFNS) gathered one of these work groups with this same purpose. In this paper, the authors intend to review and update this subject discussing the role of drugs like antivirals, antidepressants, certain anticonvulsants (gabapentin and pregabalin) and topical lidocaíne, whose therapeutic efficacy is well established in PHN. The role of opioids and capsaicin is also subject of reflection, as well as certain thera- peutic strategies recently identified as promising alternative options. Among these, the authors highlight transcutaneous electrical nerve stimulation (TNS), botulinum toxin and inhibitors of tumor necrosis factor alpha. It is widely recognized that control of pain in PHN often proves to be a challenge, requiring a delicate balance between therapeutic efficacy and side effects commonly experienced by an elderly population, often polymedicated and with multiple comorbidities. KEYWORDS – Drug therapy; Combination; Neuralgia, Postherpetic/drug therapy; Guideline. 
publishDate 2013
dc.date.none.fl_str_mv 2013-04-20T00:00:00Z
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dc.source.none.fl_str_mv Journal of the Portuguese Society of Dermatology and Venereology; Vol 70 No 4 (2012): Outubro-Dezembro; 451-457
Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 70 n. 4 (2012): Outubro-Dezembro; 451-457
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