BMJ 2001;322:859 ( 7 April )

Letters

Postherpetic neuralgia

    Findings differ from earlier results
    Authors' reply
    Pathogenesis of postherpetic neuralgia should be determined
    Treatment with amitriptyline is cheaper than with aciclovir
    Why burden the pain clinic?

Findings differ from earlier results

The first 150 words of the full text of this article appear below.

EDITOR---The article by Helgason et al provides new data about the prevalence of postherpetic neuralgia in Iceland.1 Their findings differ markedly in some respects from earlier retrospective findings. Two points in particular are at variance with British and American studies. The first is the proportion of patients with herpes zoster who develop postherpetic neuralgia and its duration. The Icelandic values are lower in both categories than those previously published from other countries.

A datum that is unfortunately missing from all studies is the age at which chickenpox, and therefore immunity, was acquired. It is well known anecdotally that postherpetic neuralgia is both rarer and less severe in people born on the Indian subcontinent; and there is considerable evidence that chickenpox occurs at a later age in this population.2 Most doctors working in pain clinics have seen patients with severe postherpetic neuralgia of 20 or more years' duration. Most such . . . [Full text of this article]
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