Question:
What is post-herpetic neuralgia? The doctor says that is what is causing the pains on the side of my face. I had a rash on the inside of my arms, but not on my face. That's why I'm puzzled about my diagnosis. Should I be?
Answer:
Post-herpetic neuralgia is a painful condition that follows an outbreak of "shingles." The medical term for "shingles" is "herpes zoster," because the condition is usually caused by a herpes virus called varicella-zoster virus, which also causes chickenpox. This virus infects nerves, including the nerve endings in the skin. After living quietly in one or more nerves for many years, the virus can "reawaken" and start to reproduce itself, causing inflammation of the nerve. That causes pain, as well as a rash that usually looks like multiple small blisters surrounded by redness.
Shingles most often occurs in just one nerve. Since all of the body's nerves are duplicated, with one nerve going to the right side and another going to the left side, shingles typically occurs on one side of the body. Sometimes, though, shingles occurs in multiple nerves at about the same time. That can make things confusing. Sometimes the pain of shingles occurs without the rash. Much less often, the rash occurs without the pain. This also can make things confusing.
What I think may have happened with you is that shingles occurred in a nerve to your face and in nerves to your arms — causing pain but not a rash in a facial nerve, and pain with a rash in nerves of your arms. It's not surprising you're puzzled, since this does not happen very often. I'll bet your doctor was initially puzzled, as well. I hope you're on the mend. Post-herpetic neuralgia usually goes away permanently, but it can take months.
