中風病患之帶狀皰疹後神經痛之處理：文獻回顧

Management of Postherpetic Neuralgia in Stroke Patients: A Literature Review

帶狀皰疹後神經痛是帶狀皰疹最常見的併發症，疼痛可能持續數年甚至終生，且可能影響病患生活的許多面向，包括睡眠、情緒、身體功能及生活品質等。帶狀皰疹及帶狀皰疹後神經痛的發生率跟中風一樣會隨著年齡增加。帶狀皰疹發生後，中風的危險性也會暫時增加，因此同時有中風及帶狀皰疹後神經痛的患者數目會隨著年齡增加。帶狀皰疹後神經痛的處理仍相當棘手，目前沒有治癒的方法，只能症狀治療以減輕疼痛的程度及縮短疼痛的持續時間。中風患者通常年紀較大，有許多共病症，服用多種藥物，且容易發生與治療相關之不良事件。中風病患之帶狀皰疹後神經痛之處理仍沒有共識，目前主要藉由在一般族群之處置實證為基礎。本文回顧中風與帶狀皰疹間關係及帶狀皰疹後神經痛之處理的文獻，並探討於中風病患之處置。

Postherpetic neuralgia is the most common complication of herpes zoster. The pain may persist for years or for life, and may interfere with patient in multiple aspects such as sleep, mood, physical function and quality of life. The incidence of herpes zoster and postherpetic neuralgia as well as stroke both increase with age. Following herpes zoster, the risk of stroke is raised temporarily, hence the number of individuals concurrently having stroke and postherpetic neuralgia increases with age. Management of postherpetic neuralgia remains challenging. So far no cure existed for postherpetic neuralgia, only symptomatic treatment aimed to attenuate the severity and shorten the duration of the pain. Stroke patients are usually older with multiple comorbidities, taking polypharmacy, and are vulnerable to treatment-related adverse events. There is no consensus in the management of postherpetic neuralgia in stroke patients. The management mainly based on the established evidence in the general population. We reviewed the literature of the correlation between stroke and herpes zoster and of the management for postherpetic neuralgia, and discussed the management in stroke patients in this article.