Peripheral Neuropathies: Shingles

Shingles is a painful condition that often follows chickenpox, decades later.

Shingles, also called Herpes Zoster,“zoster”, or “zona”, is a condition that causes numerous painful side effects. It is caused by the dormant Varicella Zoster virus, which hides in the nerves for years following Chickenpox. Shingles can cause a wide array of symptoms affecting the skin & nervous system, commonly including a blistery rash, sores, joint pain, problems with vision or taste, and swollen glands.

The effects on the skin are where the disease gets its namesake: The rash it creates follows dermatomes (patches of skin that follow a single spinal nerve), creating patterns of red, bumpy, blistered patches, resembling the shingles on a house or roof. Though the rash may clear up within a few weeks, many carriers of the virus will continue to suffer nerve pain and peripheral neuropathy for months, or even years, following medical treatment.

Causes and Risk Factors of Shingles

Other factors increasing the risk of contracting Shingles include people who: Shingles can affect anyone, but the chances of contracting Shingles increase based upon whether the patient had previously contracted chickenpox, or if they had never received the varicella vaccine. Shingles itself contagious, especially if the contact is with someone who has never had chickenpox or the varicella vaccine, although in that case, the person would more likely develop chickenpox than shingles.

• Are over the age of 60
• Have lowered immune-response due to medication or disease
• Contracted chickenpox as an infant
• Have increased stress
• Are constantly fatigued
• Have cancer, or who are currently undergoing radiation treatments
• Have a sustained injury of the skin
• Are carriers of HIV (or whom are afflicted with AIDS)
• Are pregnant

Effects of Shingles

The most tell-tale sign of Shingles is the blister-ridden rash that forms on the skin. Commonly, the rash appears localized in bands or patches, but sometimes it sporadically pops up all over the body. Like chickenpox, the blisters break causing small sores with a hard crust. Typically, the crust fades away and the sores heal within a few weeks. In some cases, the rash affects the face and can cause Ramsay Hunt Syndrome (see below).

Other symptoms of Shingles include:

• Abdominal pain
• Fever and chills
• General ill feeling
• Genital sores
• Headache
• Joint pain
• Swollen glands (lymph nodes)
• Postherpetic Neuralgia (most common in those over 60)

Ramsay Hunt Syndrome

Ramsay Hunt Syndrome (RHS) is caused by the same virus that causes shingles and chickenpox and happens when the virus attacks the nerve behind the inner ear, affecting one side of the face and head. It can cause a painful rash anywhere within the head, including the eardrum or ear canal, tongue, roof of the mouth, and on the face.

Severe cases sometimes lead to hearing loss on the affected side of the head, in some cases permanently. The affected side can also lead to a number of issues causing stroke-like weakness.

RHS issues may include:

• Difficulty closing one eye
• Difficulty eating (food falls out of the weak corner of the mouth)
• Difficulty making expressions, uncontrolled grimacing
• Difficulty with fine movements of the face
• Facial drooping
• Paralysis of one side of the face
• Spasms of the face
• Damage to the eye, or loss of motion
• Problems tasting

Sometimes, Ramsay Hunt can also cause vertigo, a sensation of things spinning or appearing blue. In most cases, the symptoms go away within a few weeks. However, in instances of severe nerve damage, the symptoms can prevail for months, if even ever fully clearing up. Treatment for Ramsay Hunt Syndrome follows a similar chain of medications and other methods used for treating Shingles.

Treatment of Shingles

To help further control pain and itching, hydrocortisone, calamine lotion, and oatmeal baths may provide relief.The first method of treatment should be administered as soon as possible, preferably at the first sign of pain, burning, or rash. This would include anti-viral medications by pill or IV. There may also be an administration of corticosteroids for swelling, antihistamines to aid with itching, and pain medications to control pain. In some cases, doctors may also prescribe capsaicin creams to prevent neuralgia.

Since the rash is highly contagious, great care should be used in decontaminating bed linens and other possessions affected by Shingles.

Prevention of Shingles

There are Shingles vaccinations available, although they are not typically administered to those under 60 years of age. If you have not been vaccinated, you should take great caution when exposed to anyone with shingles or chickenpox, as it is highly contagious, especially when the sores are oozing. However, regardless as to whether or not someone has had chickenpox or the vaccine, they can still be susceptible to catching the virus.