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Postherpetic neuralgia (PHN) is neuropathic pain that occurs due to damage to a peripheral nerve caused by the reactivation of the varicella zoster virus (herpes zoster, also known as shingles). PHN is defined as pain in a dermatomal distribution that lasts for at least 90 days after an outbreak of herpes zoster. [1]
Herpes simplex, often known simply as herpes, is a viral infection caused by the herpes simplex virus. [5] Herpes infections are categorized by the area of the body that is infected. The two major types of herpes are oral herpes and genital herpes, though other forms also exist. Oral herpes involves the face or mouth.
Sometimes, the viruses cause mild or atypical symptoms during outbreaks. However, they can also cause more troublesome forms of herpes simplex. As neurotropic and neuroinvasive viruses, HSV-1 and -2 persist in the body by hiding from the immune system in the cell bodies of neurons, particularly in sensory ganglia.
Another strain, HSV-2 usually causes genital herpes, although the strains are very similar and either can cause herpes in any location. While the disease is commonly passed through normal human contact, it is strongly associated with contact sports—outbreaks in sporting clubs being relatively common. [2]
Genital herpes is a herpes infection of the genitals caused by the herpes simplex virus (HSV). [1] Most people either have no or mild symptoms and thus do not know they are infected. [ 1 ] When symptoms do occur, they typically include small blisters that break open to form painful ulcers . [ 1 ]
The sacral ganglia are paravertebral ganglia of the sympathetic trunk. [1]:39 As the sympathetic trunk heads inferiorly down the sacrum, it turns medially. There are generally four or five sacral ganglia. In addition to gray rami communicantes, the ganglia send off sacral splanchnic nerves to join the inferior hypogastric plexus.
The short- and long-term pain caused by shingles outbreaks originates from inflammation of affected nerves due to the widespread growth of the virus in those areas. [ 47 ] As with chickenpox and other forms of alpha-herpesvirus infection, direct contact with an active rash can spread the virus to a person who lacks immunity to it.
Most viruses that enter can be opportunistic and accidental pathogens, but some like herpes viruses and rabies virus have evolved in time to enter the nervous system efficiently, by exploiting the neuronal cell biology. While acute viral diseases come on quickly, chronic viral conditions have long incubation periods inside the body.