What are the other Names for this Condition? (Also known as/Synonyms)

• Painful Trigeminal Neuropathy due to Herpes Zoster
• Painful Trigeminal Neuropathy due to Shingles
• Trigeminal Neuropathic Pain Attributed to Shingles

What is Painful Trigeminal Neuropathy Attributed to Herpes Zoster? (Definition/Background Information)

• The trigeminal nerve, or cranial nerve 5, is a highly complex bundle of nerves with both sensory and motor function. It is responsible for varied facial sensations and jaw muscle actions such as biting and chewing. The trigeminal nerve has three main branches/divisions, namely the ophthalmic nerve, maxillary nerve, and mandibular nerve
• Painful trigeminal neuropathy may be described as continuous to near-continuous pain, typically felt on one side of the face, from involvement of one or more trigeminal nerve branches. The variable intensity pain appears as a stinging (pins and needles) pain or burning pain and is generally non-triggered. Unlike trigeminal neuralgia, brief episodes of severe pain is not a common occurrence in painful trigeminal neuropathy
• Painful Trigeminal Neuropathy Attributed to Herpes Zoster is a pain disorder that occurs secondary to acute herpes zoster. Herpes zoster, or shingles, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV). This skin condition is exclusively described in individuals who had had a past history of chickenpox; also, immunocompromised individuals have a higher risk for the same. The infection affects the nervous system causing the formation of tiny red blisters on the body, among other symptoms
• In about 10-15% of the acute herpes zoster cases, the trigeminal nerve is affected, predominantly involving the ophthalmic nerve branch (in 4 out of 5 cases). Painful Trigeminal Neuropathy due to Herpes Zoster may cause shooting, stabbing, or burning pain, accompanied by allodynia (nerve pain) of skin

The criteria for diagnosis of Painful Trigeminal Neuropathy Attributed to Herpes Zoster as outlined by the International Headache Society (IHS) is given below:

• Unilateral facial pain in the distribution(s) of a trigeminal nerve branch or branches, lasting less than 3 months
• One or more of the following:
  • Herpetic eruption has occurred in the same trigeminal distribution
  • Varicella zoster virus (VZV) has been detected in the CSF by polymerase chain reaction (PCR)
  • Direct immunofluorescence assay for VZV antigen or PCR assay for VZV DNA is positive in cells obtained from the base of lesions
• Not better accounted for by another ICHD-3 diagnosis

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)