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In some people, shingles can reactivate presenting as zoster sine herpete: pain radiating along the path of a single spinal nerve (a dermatomal distribution), but without an accompanying rash. This condition may involve complications that affect several levels of the nervous system and cause many cranial neuropathies , polyneuritis , myelitis ...
So the pain is "referred to" the related dermatomes of the same spinal segment. [3] Viruses that lie dormant in nerve ganglia (e.g. varicella zoster virus, which causes both chickenpox and shingles), often cause either pain, rash or both in a pattern defined by a dermatome (a zosteriform pattern). However, the symptoms may not appear across the ...
Years or decades later, shingles occurs when virions in a single ganglion reactivate, travel down nerve fibres and infect the skin around the nerve. The shingles rash is restricted to the area of skin supplied by a single spinal nerve, termed the dermatome. Exactly how VZV remains latent in the body, and subsequently reactivates, is unclear.
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 ]
Varicella zoster virus is known to recur (after its initial presentation as chicken pox) as herpes zoster ("shingles"). Chicken pox appears nearly everywhere on the body, but herpes zoster tends to follow one or two dermatomes; for example, the eruptions may appear along the bra line, on either or both sides of the patient. [citation needed]
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The varicella zoster virus also notably may cause recurring pain and tingling in skin or tissue along the distribution path of that nerve (most commonly in the skin, along a dermatome pattern, but sometimes feeling like a headache, chest or abdominal pain, or pelvic pain). [citation needed]
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