Post-herpetic Neuralgia

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A complication of shingles (herpes zoster). 

Clinical presentation 

Intense pain described as burning, stabbing, or gnawing. 

Pharmacological Treatment 

A: amitriptyline (PO) 25mg at night, may be increased to 150mg at nightfor 4 weeks 

OR 

D: pregabalin (PO) 75-150mg 24hourly or divided doses for 2-4weeks 

Referral:  Refer  immediately  to  Ophthalmologist  in  case  of  herpes  zoster  ophthalmicus  for  atropinization