{"id":1526,"date":"2017-04-24T15:33:06","date_gmt":"2017-04-24T13:33:06","guid":{"rendered":"http:\/\/www.modernmedia.co.za\/modernmedicine\/?p=1526"},"modified":"2017-04-24T15:33:06","modified_gmt":"2017-04-24T13:33:06","slug":"postherpetic-neuralgia-how-to-prevent-it-how-to-treat-it","status":"publish","type":"post","link":"http:\/\/www.modernmedia.co.za\/modernmedicine\/?p=1526","title":{"rendered":"Postherpetic Neuralgia How to prevent it, How to Treat it"},"content":{"rendered":"<p><a href=\"http:\/\/www.modernmedia.co.za\/modernmedicine\/DigitalEditions\/mm1704-april-2017\/index.html\">Postherpetic Neuralgia How to prevent it, How to Treat it &#8211; MM1704<\/a><\/p>\n<p>Shingles, resulting from reactivation of varicella-zoster virus is a common acute disease, particularly in elderly<br \/>\nand immunocompromised patients. The shingles rash is accompanied with acute, often severe pain; the<br \/>\npersistence of neuropathic pain beyond three months is described as postherpetic neuralgia (PHN). PHN<br \/>\noccurs more often in the elderly and has significant negative effects on quality of life. Vaccination with<br \/>\nattenuated varicella-zoster virus is a preventive strategy reducing incidence of acute shingles and thereby PHN.<br \/>\nTreatment of PHN should follow established guidelines for neuropathic pain; in view of the localised pain and<br \/>\nthe typically elderly and frail patients affected, topical lignocaine 5% patch is a specific first-line treatment<br \/>\noption. Systemic first-line treatments include pregabalin, gabapentin, tricyclic antidepressants and serotonin<br \/>\nnoradrenaline reuptake inhibitors, with tramadol secondline and conventional opioids third-line options.<\/p>\n<p><em>Modern Medicine \u2013 April\u00a02017<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Postherpetic Neuralgia How to prevent it, How to Treat it &#8211; MM1704 Shingles, resulting from reactivation of varicella-zoster virus is a common acute disease, particularly in&#46;&#46;&#46;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2},"beyondwords_generate_audio":"","beyondwords_project_id":"","beyondwords_content_id":"","beyondwords_preview_token":"","beyondwords_player_content":"","beyondwords_player_style":"","beyondwords_language_code":"","beyondwords_language_id":"","beyondwords_title_voice_id":"","beyondwords_body_voice_id":"","beyondwords_summary_voice_id":"","beyondwords_error_message":"","beyondwords_disabled":"","beyondwords_delete_content":"","beyondwords_podcast_id":"","beyondwords_hash":"","publish_post_to_speechkit":"","speechkit_hash":"","speechkit_generate_audio":"","speechkit_project_id":"","speechkit_podcast_id":"","speechkit_error_message":"","speechkit_disabled":"","speechkit_access_key":"","speechkit_error":"","speechkit_info":"","speechkit_response":"","speechkit_retries":"","speechkit_status":"","speechkit_updated_at":"","_speechkit_link":"","_speechkit_text":""},"categories":[1],"tags":[],"class_list":["post-1526","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5REYo-oC","_links":{"self":[{"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/posts\/1526","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1526"}],"version-history":[{"count":1,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/posts\/1526\/revisions"}],"predecessor-version":[{"id":1527,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=\/wp\/v2\/posts\/1526\/revisions\/1527"}],"wp:attachment":[{"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1526"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1526"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modernmedia.co.za\/modernmedicine\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1526"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}