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Gabapentin, sold under the brand name Neurontin among others, is an anticonvulsant medication primarily used to treat neuropathic pain and also for partial seizures [10] [7] of epilepsy. It is a commonly used medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain. [11]
A generic version of gabapentin first became available in the United States in 2004. [46] An extended-release formulation of gabapentin for once-daily administration, under the brand name Gralise, was approved in the United States for the treatment postherpetic neuralgia in January 2011. [47] [48]
Postherpetic neuralgia is the most common long-term complication of herpes zoster, and occurs in approximately 20% of patients with shingles. [2] Risk factors for PHN include older age, severe prodrome or rash , severe acute zoster pain, ophthalmic involvement, immunosuppression , and chronic conditions such as diabetes mellitus and lupus . [ 1 ]
Eye involvement: trigeminal nerve involvement (as seen in herpes ophthalmicus) should be treated early and aggressively as it may lead to blindness. Involvement of the tip of the nose in the zoster rash is a strong predictor of herpes ophthalmicus. [77] Postherpetic neuralgia, a condition of chronic pain following shingles.
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
Neuropathic pain and post-herpetic neuralgia can commonly persist for more than 3 months and a year to 18 months is not uncommon. More than 50% of patients report experiencing post-herpetic neuralgia. [2] Post-herpetic fatigue is also a common long term side effect and may persist for several months to a year or more.
Pregabalin and gabapentin may reduce pain associated with diabetic neuropathy. [28] [26] [29] [30] The anticonvulsants carbamazepine and oxcarbazepine are especially effective in trigeminal neuralgia. Carbamazepine is a voltage-gated sodium channel inhibitor, and reduces neuronal excitability by preventing depolarisation. [31]
Other, infrequent causes of pudendal neuralgia are viral infections (HIV, herpes zoster or herpes simplex), multiple sclerosis, inflammatory demyelinating polyneuropathy, [10] proctalgia fugax, [10] pelvic floor spasm, [10] and diabetes. [15] Postherpetic neuralgia, which is persistent pain due to nerve damage after shingles, is another ...