Herpes Zoster: Postherpetic Neuralgia and Other Complications

Dr C. Peter N. Watson has been the chief editor of two essential editions on herpes zoster and postherpetic neuralgia.  He is a neurologist in the Department of Medicine, Division of Neurology, University of Toronto, Ontario, Canada. Dr Watson published the first well-conducted trial in postherpetic neuralgia of amitriptyline as an analgesic independent of its effects on depression. Dr Watson enjoys an international reputation for that paper and his other contributions in the same field. These include the two well used volumes Herpes Zoster and Postherpetic Neuralgia, which he both edited and wrote a considerable part of (Watson, 1993; Watson & Gershon, 2001). He wrote the chapter on this topic for Bonica’s textbook (3rd edition) and in The Textbook of Pain. His seminal study on amitriptyline was followed by a series of pioneering or definitive trials of other oral medications in postherpetic neuralgia, including maprotiline (1992), nortriptyline (1998), and oxycodone (1998). Dr Watson has received the Canadian Pain Society’s highest honour, the Distinguished Career Award, in 2003, and the medal of the Varicella Zoster Research Foundation, in 2007, for his pioneering research on postherpetic neuralgia.Dr Anne A. Gershon is a Professor of Pediatrics at Columbia University College of Physicians and Surgeons. She is a graduate of Cornell Medical School. Her research over the past 40 years has included epidemiology, diagnosis, immunology, latency, prevention, and treatment of varicella and zoster. Her studies with varicella vaccine were critical for its licensure in the United States. She is continuing to study the safety and efficacy of varicella vaccine in the “vaccine era”. She has also focused on HIV infection in children, particularly opportunistic infections. She has received research funding from NIH for the past 40 years. Dr Gershon has served on numerous national and international medical committees. She was President of the Infectious Diseases Society of America (IDSA) in 2009. She has received many professional awards including the Gold medal of the Sabin Vaccine Institute and the Fleming Award of the IDSA. She is the author of over 300 publications and has edited 11 books.Dr Michael N. Oxman is Professor of Medicine and Pathology at the University of California, San Diego and Staff Physician in Infectious Diseases at the Veterans Affairs San Diego Healthcare System. He pioneered the use of large double-blind placebo-controlled multi-centre trials to evaluate treatment and prevention of HSV and VZV infections. A student of herpes zoster for 50 years, Dr Oxman led the landmark Shingles Prevention Study, which demonstrated the efficacy of live attenuated VZV Oka zoster vaccine leading to its licensure and routine use in the US and other countries to prevent herpes zoster and postherpetic neuralgia. Dr Oxman is a recipient of the VZV Research FoundationLifetime Achievement Award, the Plenary Lectureship honouring Professor Michiaki Takahashi at the 10th Annual Meeting  of the Japanese Society of  Vaccinology,  the Stephen E. Straus Memorial Lectureship in Infectious Diseases at the NIH, the Abraham I. Braude Visiting Professorship at  UCSD,  and the Department of Veterans Affairs John Blair Barnwell  Award for outstanding scientific achievements in clinical research.

• 1. Introduction.- 2. Varicella.- 3. Herpes Zoster: A Patient’s Perspective.- 4. The Epidemiology and Natural History of Herpes Zoster and Postherpetic Neuralgia.- 5. Herpes Zoster Ophthalmicus.- 6. Neurological Complications of Herpes Zoster.- 7. The Role of Varicella Zoster Virus in Giant cell Arteritis.- 8. Herpes Zoster and Vascular Risk.- 9. Antiviral Therapy and Local Treatment for Herpes Zoster.- 10. Dermatologic Manifestations of Herpes Zoster.- 11. The Effect of Herpes Zoster and Postherpetic Neuralgia on Health-    Related Quality of Life, Function, Employment-Related Productivity, and the Cost Effectiveness of the Vaccine.- 12. The Pathology of Post-Herpetic Neuralgia and Postherpetic Itch.- 13. Neural Basis of Pain in Herpes Zoster and Postherpetic Neuralgia: the Ectopic Pacemaker Hypothesis.- 14. Persistent VZV Ganglionitis may be the Cause of Postherpetic Neuralgia.- 15. A Comparison of Clinical Features, and Mechanisms of Trigeminal Postherpetic Neuralgia and Trigeminal Neuralgia.- 16. Treatment of Post-Herpetic Neuralgia: Subtypes and a Mechanism-Based Treatment.- 17. Interventional Approaches to Postherpetic Neuralgia.- 18. Treatment of Post-Herpetic Neuralgia:  The Role of Opioids.- 19. Postherpetic Neuralgia: Difficult to Treat, Easier to Prevent.- 20. Postherpetic Neuralgia: are There Neurosurgical Options?.- 21. Designing Randomized Controlled Trials of Oral Analgesics for Chronic Postherpetic Neuralgia.- 22. The Importance of Zoster Prevention Vaccines.- 23. Aggressive Non-Invasive Treatment of Acute Herpes Zoster for the Prevention of Postherpetic Neuralgia.- 24. Herpes Zoster Vaccines.- 25. Conclusion.