Multiple lower cranial nerve palsies are a rare complication following varicella zoster virus (VZV) reactivation, especially if typical herpetic eruptions are lacking. The most common is herpes zoster, which is frequently complicated by postherpetic neuralgia, meningoencephalitis, and vasculopathy, including VZV temporal arteritis, myelopathy, and retinal necrosis. This outbreak and the last have been particularly dififcult because they originate in my left pubic area, wrap around my hip to my butt, and up my back and front to about bottom rib line. Prolonged radicular pain without zoster rash combined with the presence of varicella-zoster virus in the cerebrospinal fluid indicates that both men had zoster sine herpete, and strongly supports this syndrome as a clinical variant. It was he who explained to me that the virus simply did not make it to the surface and attached itself to the nerve. Nested and real-time polymerase chain reaction were used to validate salivary VZV DNA as a surrogate marker of VZV reactivation and then to determine the utility of that marker for the identification of those individuals within a population defined by abdominal pain that might have enteric zoster. At first I thought it was chickenpox, but I’d had that years before,” recalls a young woman who had shingles in her twenties.
I have been taking Gabapentin, Amitriptlyne Percocet and Lidocaine topical cream to treat the symptoms of PHN. While it does make the pain bearable, this simply means “I am not in tears all day” otherwise, I would be. Zoster is characterized by dermatomal distribution pain and rash (figure 1) and is frequently complicated by chronic pain (postherpetic neuralgia [PHN]) as well as meningoencephalitis, myelopathy, retinal necrosis, and vasculopathy, including multifocal VZV vasculopathy with temporal artery infection (figure 2). I even thought at one time that it was related to wheat consumption. I am also told there is nothing that can be done to correct this, only can treat the symptoms. I was glad to see that someone else besides myself have experienced this as well. Given the predilection of latent VZV in dorsal root ganglia and cranial nerve ganglia to reactivate and cause zoster, latent VZV is also likely to reactivate in the ENS to give rise to gastrointestinal (GI) dysfunction.
Scientists call the virus that causes chickenpox/shingles varicella-zoster virus or VZV. If you are able to answer 2 questions I’d appreciate it. Did you ever have a shingles vaccine? PHN is also slightly more frequent in women and after trigeminal-distribution zoster.2 PHN may be due to a chronic ganglionitis from persistent viral infection. I am wondering if people who get canker sores on their mouth are more apt to get shingles. I get those sores alot and am very worried I’ll get the worst case of shingles! No, I’ve never had the vaccine and yes, I have had canker sores both in and out of my mouth, but has been quite some time since I’ve had one on my mouth and has been years since I had inside my mouth.
Since its discovery in astronauts, salivary VZV DNA has consistently been found in patients with clinical zoster  but not in healthy subjects . As early as 1909, scientists suspected that the viruses causing chickenpox and shingles were one and the same. You usually have to start at very low doses (ie 100 mg gabapentin) and go up very slowly. The max dose of gabapentin is 1200 mg three times daily if you can tolerate this; nortriptyline has less side effects than amitriptyline and 40 mg is a good dose to work up up to – caution with heart rhythm problems. Under monitored anesthesia care, stimulating electrodes are placed subcutaneously over the area of maximal pain. Treatments often fail because the dose is not high enough or the doc went up too fast on the meds and the patient doesn’t have time to get used to side effects. If the meds the neurologist prescribes don’t work out or the side effects are too bad – last resort is Pain Specialist.
They inject a nerve block (similar to lidocaine) to numb up the nerve. Postrecovery saliva served as each patient’s internal control. The viruses multiply, the telltale rash erupts, and the person now has herpes-zoster, or shingles. Sometimes it can be a pinched nerve which is more obvious on imaging now than in the past. Or even a cyst rubbing on that nerve to cause constant pain. Immunocompromised patients or those with recurrent VZV vasculopathy may need a longer course. Shingles and cold sores are caused by 2 closely related viruses – varicella zoster virus and herpes simplex virus.
They both reactivate and cause disease when your immune system is weakened (older, chemotherapy, HIV, stree, etc). HSV-1 comes out more frequently to cause cold sores. DNA was extracted with DNeasy Blood and Tissue Kit (Qiagen, Valencia, California). Sometimes these children are born with chickenpox or develop a typical case within a few days (see section entitled “Can Shingles During Pregnancy Harm the Baby?” for more information). They don’t know how well it protects after the 3 years but it is still recommended by the Centers for Disease Control if you are healthy. Originally Posted by AllaboutVZV Shingles without rash is called “zoster sine herpete”. TA biopsy revealed inflammation and VZV antigen in the adventitia, and CSF analysis revealed the presence of anti-VZV IgG antibody with reduced serum/CSF ratios of anti-VZV IgG antibody compared to ratios for albumin and total IgG, indicative of intrathecal synthesis of anti-VZV IgG antibody; vision improved after antiviral treatment.12 Overall, we have learned that in some patients who manifest clinically as GCA but whose TAs are GCA-negative, VZV infected their extracranial temporal arteries and produced temporal arteritis.
You usually have to start at very low doses (ie 100 mg gabapentin) and go up very slowly. The max dose of gabapentin is 1200 mg three times daily if you can tolerate this; nortriptyline has less side effects than amitriptyline and 40 mg is a good dose to work up up to – caution with heart rhythm problems. The percocet can have side effect of headaches. WT VZV has a thymine at 106262, whereas vOka has a cytosine . The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. They inject a nerve block (similar to lidocaine) to numb up the nerve. If this works, they inject phenol to essentially “cut” the nerve to prevent it from sending the pain signal to your brain – repeat every 3-4 months and can lower your oral meds.
Zoster sine herpete is defined as chronic radicular pain without rash caused by VZV. Sometimes it can be a pinched nerve which is more obvious on imaging now than in the past. Or even a cyst rubbing on that nerve to cause constant pain. Good luck! Nuclei were stained with bisbenzimide (Sigma-Aldrich, St Louis, Missouri) (see Supplementary materials for additional details). Shingles attacks can be made less severe and shorter by using prescription antiviral drugs: acyclovir, valacyclovir, or famcyclovir. The Pain Specialist that I now have has been able to get me a ‘Spinal Cord Stimulation Trial’ (SCST) I am so looking forward to this.
Actually this will be my second attempt, the first procedure didn’t get a chance to work because, I accidentally pulled the ‘wire’ down from my 6th vertebrae to the 10th, within less than 24 hours. Multifocal, discrete opacified lesions begin in the outer retinal layers peripherally or posterior pole; only late in disease are inner retinal layers involved. I was devastated that I had done that and being it is an expensive procedure, my doctors had to plead with the insurance company to allow another trial. Thank God the doctors were successful, I go in for the procedure on Monday. The trial is a 7-day period to determine whether or not the stimulation will help control the pain so I can at least have somewhat of a normal day. Salivary VZV DNA, collected while pain was present, was detected in 2 of 2 patients (P < .01 vs control; Figure 1B) and disappeared in each person after recovery (Table 2). A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles.
I pretty much control the pain. I am certainly anxious to see if the trial works and how it will be to have a device attached to my body. Zoster vaccine is safe and effective. Sounds simply enough, lets hope it is. Yes I received a MRI, 2 in fact, they were by 2 different doctors, 2 years apart too. The first was with contrast and and revealed no signs of anything. Frequency of salivary varicella zoster virus (VZV) DNA in saliva of negative control (healthy) subjects, positive control (zoster/varicella) subjects, patients with zoster sine herpete, and patients with unexplained abdominal pain (without rash).
Some scientists believe that immunizing children against chickenpox increases the risk of shingles in adults who were not themselves immunized during childhood. I have every test/results that I have had done to me on my thumb drive. I have this thumb drive with me at all times. Unlike type 1 herpes simplex virus (HSV), which reactivates from latency in cranial nerve ganglia to produce mucosal lesions around the mouth and nose, and unlike type 2 HSV, which is latent in sacral ganglia and reactivates to produce genital herpes, VZV is latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis; thus, zoster can occur anywhere on the body. So, yes, the results are accurate. Hi there, I was reading your question and wanted to let you know that I am currently suffering from my second case of shingles that I am aware of. I never had the shot and I have never had canker sores before, however I used to get nerve pain really bad and thought it was just my sciatica and I also have had a lot of pain under my left rib cage which I associated with an ulcer…
The case of 1 patient from group 4, which is particularly noteworthy because it demonstrates that vOka can cause enteric zoster, has been reported to the Worldwide Adverse Experience System and to the US Food and Drug Administration. – involved more than 38,000 veterans aged 60 and older. The dr. has me on an anti viral medication which im suppose to take at the first signs of it. Furthermore, even without rash, VZV should be considered as a possible etiologic agent. Hello I want to know what doctor are u seeing .. i am a 31 yr old female in tucson and I had shingles twice in 2013 ..
Both times being hospitalized as I was 7 months pregnant in the 1st bout .. Respiratory failure requiring intubation occurred and aspiration pneumonia was identified. The TCA amitryptiline was commonly prescribed in the past, but although effective, it has a high rate of side effects. Pain in my breast where I got it .. and all thru my back .. The worst thing is I already have slipped disks so at times I confused the pain .. i can’t take it anymore !
And even well in the hospital they accused me of just wanting pain meds .. even though I had shingles a second time in 5 months my kidneys and liver where failing and swollen and they still said I was there for pain meds very upsetting I have no history of drug use and further more I left my new born baby and was very depressed and had to stop breast feeding beCuz of this .. Intact neurons were not encountered in the expected region of the myenteric plexus (Figure 2D), despite examination of multiple sections and immunostaining with antibodies to the neuronal marker PGP9.5 (data not shown). They include oxycodone, morphine, tramadol, and methadone. Please help ! I am a 34 year old female who has been suffering from major rib pain for two years now. I have been sent to seven different specialist who all told me it wasn’t there area and referred me to someone else.
Finally, I went to see a Rheumatologist and she told me that it was PHN without doing any test to confirm so. However, I have never had shingles. I am worried about this diagnosis but I am seeing there are others afflicted just like me. Saliva was free of VZV DNA 3 weeks after discharge, when the gastric mucosa was found endoscopically to be normal and mucosal biopsies contained no detectable VZV DNA; moreover, immunocytochemical examination of biopsied tissue revealed no immunoreactivities of gE or ORF63p (Figure 4A1–A6). Clinical experience suggests that postherpetic itch is harder to treat than postherpetic neuralgia. I hope you are feeling better by now. I found your thread by searching for people who had experienced PHN without ever having had a rash, because I’m pretty sure that’s what’s going on.
I haven’t been examined by a doctor, but a doctor I know thought this seemed plausible when I described what was happening. Never had a rash, but I keep looking for one and being astonished not to see anything because what I’m feeling sounds exactly like every description of shingles pain I have ever heard. I’m trying to be grateful that I never had the flu-like symptoms, that it has been intermittent (there are hours at a time when I don’t notice a thing) and that even at its most painful I’ve been able to carry on my normal activities. Even so, it’s slowly wearing on my emotions. Hematoxylin and eosin (H&E) stain; scale bar = 100 µm. People with shingles need to seek immediate medical evaluation if they notice neurological symptoms outside the region of the primary shingles attack. I’m at the point of praying for a rash to actually appear, because then I’d know for sure it was shingles instead of something even worse.
I doubt antivirals would do any good at this point because it’s been about 2 months since this started, and I don’t want to take any strong painkillers because of the side effects. Anyway, it has been somewhat helpful to come to this thread and find that there really IS such a thing as PNH following a no-rash shingles episode, and maybe this isn’t all in my head. Maybe people who get the rash tend to avoid getting PHN because it’s immediately obvious they need antivirals, while those who don’t get the rash also don’t realize they need treatment and then there’s nerve damage? I am noticing incremental improvement. Really, each week has been better than the previous one; it’s just that there are periodic bad days that make me feel like I’m never ever going to feel normal again, and the day I posted was one of them. B, Control immunoreactivity. Most experts agree that shingles in a pregnant woman, a rare event, is even less likely to cause harm to the unborn child.
I really, really, really want some coffee, but that’s one thing that seems to spike the pain, which would make me grouchier! Thanks for asking. I had the same thing. Felt like a knife stabbing me in the back off to one side a bit of the spine for weeks. Then the doctor said I had shingles. I did eventually develop a rash. A1–6.
If these babies develop chickenpox as a result, it can be fatal. Today he said it might be dermatomyositis. All I know is I am going crazy with this itching on my chest now and onto the face some.