Burning pain along the nerves in the chest or trunk or in the face and eye, usually on one side only, is called shingles or herpes zoster.
A few days after the disease begins, redness and small, fluid-filled blisters appear in the area where the pain occurs. These symptoms last for about a week.
It is an infectious disease caused by the varicella zoster virus. It is accepted that the virus settles in the posterior roots of the spinal cord and becomes active for some reason, causing symptoms. The virus can remain silent for years without causing any symptoms.
Signs and Symptoms
The complaints that occur depend on which nerve root is affected. Blisters that sometimes start with itching and cause mild pain and sometimes cause very severe pain (burning pains of the causalgia type) are seen in the area where the affected nerve radiates.
These bubbles are usually found in small groups (3-5 together).
Sometimes there are many bubbles, sometimes there are few bubbles.
The intercostal nerves are most commonly affected.
The blisters remain on one side of the body and do not cross the midline. The blisters usually disappear in 1-3 weeks, but dark spots remain in their place. When you press on these spots, severe pain lasts for a few minutes. This pain can last for months or years (this condition is called post-herpetic neuralgia).
If some of the cranial nerves are affected, temporary facial paralysis, ear problems, and eye problems may occur.
Widespread shingles affecting the entire body may be seen in lymphoma patients.
Treatment
Applying talcum powder and ointment (oxyde zinc) to the blisters can help reduce pain and itching. These also help prevent other infections that may occur around the blisters. Vitamin B may be helpful.
If the pain is not too severe, painkillers such as aspirin and paracetamol may be sufficient, but for very severe pain, injection-type painkillers are necessary.
In severely ill patients, corticosteroids should be given, along with antibiotics.
Nerve blocking drugs are given to those with burning pain of the causalgia type; such drugs may not be used in those with heart disease, especially those with coronary heart failure.
In severely ill patients and in cases where blisters and pain are widespread, it may be necessary to use antiviral drugs (effective against viruses).
In the post-herpetic neuralgia period, the drugs listed above are generally not useful. Psychiatric drugs such as antidepressants are generally used.
