Q: My 58 years old father got infected with Varicella Zoster Virus (VZV) two months back. After the initial medication for a week, the shingles were gone and the affected area of the skin affected healed. Now, after two months, he is having post herpetic neuralgia. His skin has become very sensitive and he experiences burning sensation and pain accompanied by seizures. What mode of treatment should we take now? How long will it take for my father to get treated completely?

A:Post herpetic neuralgia can be very troublesome. Greater the age at which herpes zoster occurs, greater is the probability that the neuralgia which is likely to occur, is going to be more severe. The only way to minimise it is to start aggressive antiviral therapy within the first 72 hours, preferably within the first 48 hours. Once it occurs, one has to learn to live with it, along with minimum medication possible. Gradually the medicines may have to be stepped up, so that the neuralgia becomes bearable. Medicines may have to be continued till neuralgia abates on its own. When this will happen cannot be predicted (sometimes after several months). In a rare case where medicines are ineffective or cannot be given for some reason, rhizotomy and cordotomy may be done provided local nerve block has been effective.