13.1.2.2 Post-herpetic trigeminal neuropathy

Previously used term:
Post-herpetic trigeminal neuralgia.

Description:
Unilateral head and/or facial pain persisting or recurring for at least three months in the distribution of one or more branches of the trigeminal nerve, with variable sensory changes, caused by Herpes zoster.

Diagnostic criteria:
A. Unilateral head and/or facial pain persisting or recurring for ≥3 months and fulfilling criterion C
B. History of acute Herpes zoster affecting a trigeminal nerve branch or branches
C. Evidence of causation demonstrated by both of the following:

    1. pain developed in temporal relation to the acute Herpes zoster
    2. pain is located in the distribution of the same trigeminal nerve branch or branches

D. Not better accounted for by another ICHD-3 diagnosis.

Comments:
Following acute Herpes zoster, post-herpetic neuralgia is more prevalent in the elderly.

The first division of the trigeminal nerve is most commonly affected in 13.1.2.2 Post-herpetic trigeminal neuropathy, but the second and third divisions can be involved also. Typically the pain is burning and itching. Itching of affected areas may be very prominent and extremely bothersome. Sensory abnormalities and allodynia are usually present in the territory involved. Pale or light purple scars may be present as sequelae of the herpetic eruption.