Definition

Posthetherpetic Neuralgia is a complication ofCLous zoster infection (snake). Herpes zoster is caused by reactivation of the virus variricella zoster, which is the virus that causes chickenpox.pox is one of the frequent viral infections that occurs when children are children, or so-called variricella. Herpes zoster causes skin rashes with small lumps of pain accompanied by pain. Ruam occurs most often on one side of the body and forms a circular pattern. When the rash disappears, pain may persist, this persistent pain is called posthetherpetic neuralgia. As many as one in five patients who experience▁sakitzoster experience post herpetic neuralgia. Postherapetic neuralgia risk factors increase with age (>60 years old) and a weak immune system. There is no specific treatment for treating postherapetic neuralgia, but treatment is focused on preventing populations that have a high risk and to reduce symptoms.

Cause

Neuralgia posthethepetic occurs due to damage to nerve fibers during partozoster infection. Herpes zoster is caused by the virus variricella zoster, viruses that also cause chickenpox. After suffering from chickenpox, the virus will remain in the body, but the virus is inactive (dorman) or sleep for years. When the virus is reactivated (reactivation), it will causeZZer (fire/water spots). The nerve fibers in the infected area can be damaged resulting in interference in sending signals to the brain. As a result of the damage, it can cause symptoms in the form of severe pain, which can arise for months to years. Postheretic Neuralgia means nerve pain after Alzheimer's infection. 

Risk Factors

The occurrence of postherapetic neuralgia is closely related to the immune system and the history of herpes zoster you have experienced. In addition to age-added, another factor that can put you at risk of having a posthetherpetic neuralgia is:

1. Age above 50 years.
2. The history oflicity zoster and the location of occurrence in the face and chest area. 
3. Another history of disease that can lower the immune system such as diabetes mellitus.
4. Psychozoster treatment has been given for more than 72 hours since the appearance of symptoms.
5. Heavy history of pain.

The location of the fear of zoster has a connection with the possibility of repeated pain or posthetherpetic neuralgia. Based on the location of thection of the zoster, the risk of postherapetic neuralgia in a person can be sorted into:

1. Low risk: Jaw, Neck, and Back at the bottom.
2. Medium risk: Dada.
3. High Risk: Trigeminal (trigeminal areas are areas of forehead, cheeks and lower jaw. Especially when it comes to eye nerves), brachial plenary (regions persarafi from brachial plenaries are shoulder muscles, elbows, wrists, and fingers). 

Symptoms

Pain is one of the symptoms that the patient complains about. If you experience posthetherpetic neuralgia, the location of the pain is in the same place as the appearance of the Zoster Herpes. The pain that arises can have several characters in the form of:

1. Pain is like a burning sensation or sharp pain.
2. The pain that disappears arises without any excitation from outside.
3. Rangsangan yang tidak menyebabkan a pain, namun dirasakan sebagai api (semoran: sentuhan dirasakan sebagai api atau rasa terbakar).
4. The pain felt is getting more and more severe at night, the temperature is hot or cold.

Pain can last for more than three months with characteristics of burning or pain like being stabbed. In addition to pain, other neurological disorders are a decrease in response to external stimuli or baal and numbness and itching. 

Diagnosed

In diagnosing the posthethepetic neuralgia, doctors will ask about medical history including a history of herpes zoster disease. This complaint is important to ask because posthereptic neuralgia is caused by the reactivation of the virus variricella zoster which causes herpes zoster. Then the physical examination will see and look for other causes of the pain that arises. The examination carried out in the pain area is an examination to assess the response to the stimulation given such as using cotton and a tooth stick. Some examples of questions you can receive are:

1. Do the symptoms experienced continuously or disappear arise?
2. How severe are the symptoms you experience? (Doctors can ask about the scale of pain on a scale of 1-10)
3. Do you have a history of chickenpox? When did you experience chickenpox?
4. Have you received the herpes zoster vaccine?
5. Are the factors that can relieve or increase the symptoms you are experiencing?
6. Are you experiencing or having a history of other diseases such as immune disorders or cancer treatment?

Laksana Procedure

The purpose of postherapetic neuralgia therapy is to control pain and reduce other symptoms. Until now, special treatment has not been found in treating posthetherapetic neuralgia, but some drugs have been shown to reduce pain. The use of free-buying anti-pain drugs such as paracetamol and ibuprofen cannot reduce pain due to postherapetic neuralgia. Doctors can prescribe one of the drugs below to reduce pain:

1. Gabapentin and pregabalin.
2. Drugs used to treat depression disorders such as amitryptin, nortryptin, or despiramin.
3. Use of narcotics class drugs in the form of drugs patch like lidokain patch or cream. This drug is the second line of treatment for postherapetic Neuralgia such as oxicodone, morphine, tramadol.

In addition to drug administration, the therapy that can be given is:

1. The injection therapy that can be given is the injection of glucorrhyroids in patients whose pain is not reduced using drugs.  
2. The provision of electricity or the use of Transcutaneus Electrical Nervice Simulation (TENS) in small amounts in areas where pain can reduce the intensity of pain.
3. The use of cold compresses in painful areas.
4. Wearing comfortable clothes such as cotton or silk.

Complications

The complications due to postherapetic neuralgia that arises depend on the length of the disease and the level of pain. Postherapetic Neuralgia can cause:

• Depression
• Fatigue
• Sleep difficulty
• Decreasing appetite
• Difficult to concentrate

Prevention

Prevention of posthethepetic neuralgia can be done when experiencing participation. When you experience herpes zoster, it is important to do the right treatment so that it can prevent posthethetherapic neuralgia from occurring. The drugs that can be used in treating herpes zoster are acyclovir, famciclovir and valacyclovir. These drugs must use a doctor's prescription. Therapy is given within two days of the onset ofiggs zoster. The administration of the herpeszoster vaccine is considered effective to prevent shotout and postherapetic neuralgia. Vaccines are given primarily at the age of over 50 years, in two doses of vaccine with a interval of two to six months. The requirement to receive the vaccine is healthy and has a strong immune system. 

If you have one of the complaints below, you shouldn't receive the herpes zoster vaccine:

1. Having a life-threatening allergic reaction to gelatin, neomycin antibiotics or their components.
2. Has a weak immune system.
3. They are receiving steroid treatment, radiotherapy, chemotherapy, or both.
4. Has bone cord cancer or cancer in the lymphatic system.
5. Has an active tuberculosis disease and has not been treated.

When Do You Have To Go To A Doctor?

Consult to the doctor if you have early symptoms of▁sakitzoster. Often the pain begins before the skin rash. The risk of you being exposed to postherpetic neuralgia is reduced if you get antiviral treatment within 72 hours of the onset of a skin rash. 

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