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Shingles, also known as herpes zoster or zona, [6] is a viral disease characterized by a painful skin rash with blisters in a localized area. [2] [7] Typically the rash occurs in a single, wide mark either on the left or right side of the body or face. [1]
Shingles is caused by varicella zoster virus (VZV), an alpha-herpesvirus. Initial VZV infection usually occurs in childhood causing chickenpox. After this resolves, the virus is not eliminated from the body, but remains latent in the nerve cell bodies of the dorsal root or trigeminal ganglia, without causing symptoms.
A dorsal root ganglion (or spinal ganglion; also known as a posterior root ganglion [1]) is a cluster of neurons (a ganglion) in a dorsal root of a spinal nerve. The cell bodies of sensory neurons known as first-order neurons are located in the dorsal root ganglia. [2] The axons of dorsal root ganglion neurons are known as afferents.
Tarlov cysts are most commonly located in the S1 to S4/S5 region of the spinal canal, but can be found along any region of the spine.They usually form on the extradural components of sacrococcygeal nerve roots at the junction of dorsal root ganglion and posterior nerve roots and arise between the endoneurium and perineurium. [10]
Similar to the herpes simplex viruses, after primary infection with VZV (chickenpox), the virus lies dormant in neurons, including the cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia. Many years after the person has recovered from initial chickenpox infection, VZV can reactivate to cause shingles. [4]
A dermatome is an area of skin supplied by sensory neurons that arise from a spinal nerve ganglion. Symptoms that follow a dermatome (e.g. like pain or a rash) may indicate a pathology that involves the related nerve root. Examples include somatic dysfunction of the spine or viral infection.
A dorsal root ganglion (DRG) from a chicken embryo (around stage of day 7) after incubation overnight in NGF growth medium stained with anti-neurofilament antibody. Note the axons growing out of the ganglion. A ganglion (pl.: ganglia) is a group of neuron cell bodies in the peripheral nervous system.
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 ]