Post-herpetic neuralgia (PHN) due to neural tissue varicella zoster viral infection can be debilitating chronic condition characterized by pain, burning and itching sensation along the involved nerve. Although any nerve can be involved, and its related dorsal root ganglia, more commonly involved are the sensory nerves of the head and trunk, along their specific sensory distribution (dermatome).
In the United States each year approximately 1,000,000 individuals develop herpes zoster. Of those individuals approximately 20%, or 200,000 individuals, develop PHN. About 10 % of people younger than 60, and about 40 % of people older than 60 end up developing PHN.
It usually follows herpes zoster outbreak (also known as SHINGLES), but it can begin in the absence of herpes zoster, then known as zoster sine herpete. The neuralgia typically begins when the herpes zoster vesicles have crusted over and begun to heal. Pain that persists beyond three months, is defined as PHN. After the initial acutely painful nerve involvement, skin discoloration, burning and itching, symptomatic treatment usually helps temporarily control these acute events. Unfortunately viral nerve infection permanently infects the involved sensory nerve, leaving patient to deal with chronic pain, burning and or itching along involved nerve’s skin dermatome.
From this point, a number of pain treatments are offered to patients by many specialists. Since the vast majority is focused on treating patient symptoms, a solution is seldom found. Unlike other specialties, peripheral nerve surgery is focused on the anatomical cause of chronic pain, ensuring the best possible chance for cure. Dr. Ducic had pioneered application of peripheral nerve surgery in the treatment of post-herpetic neuralgia patients.