Shingles

By: Joe Hing Kwok Chu

Shingles are caused by reactivation of the chickenpox virus, varicella-zoster virus in the adults.

The virus multiples along the sensory nerves, usually outside the brain or the spinal cord. The  virus can be harbored and propagated within the large flattened sensory root ganglion of the trigeminal nerve that lies within the skull and behind the orbit (bone cavity of the eye) also called  gasserian ganglion emilunar ganglion, the intraoral mucosal surfaces innervated the second and third divisions of the trigeminal nerve may be involved.

The lesions of shingles are clustered vesicles, preceded by early symptoms of pain along the nerves. The lesions are  mostly on one side of the body and stop at the midline. They are very painful. The oral vesicles typically rupture early to form shallow painful ulcerations. Fever, malaise, and inflammation of the lymph nodes accompany the mucosal and dermal lesions, which heal slowly and often with lingering pain.

Intraoral lesions of shingles are similar to those of other herpes virus infections, coxsackie virus  infections, and of aphthae. Shingles can be differentiated from those other infections by the fact of continuous distribution of the lesions and severe pain.

When the eye division of the trigeminal nerve is infected, the cornea of the eye can be affected and affect the eye sight. When the face division of the trigeminal nerve (the seventh nerve of the brain) and the hearing division of the trigeminal nerve (the eighth nerve of the brain) are infected, it may cause paralysis of the face muscles, and hearing symptoms. When the sacrum (S₃ neuron) is affected it can cause neurotic bladder with urination difficulty or anuresis (retention of urine in the bladder) but prognosis is good.

Sometimes there are cases of bleeding and gangrenes that often result in  scare tissues.

Infections on both sides of the body rarely happen. Recurring of infections are also uncommon.

There is no effective therapy in modern medicine. Usually the therapy is mainly aiming at addressing symptoms as they show up, like pain management, and preventing secondary infections. In recent years, anti viral drug are being used e.g. Aciclovir (Zovirax) and Ftiloxazone (6133, Phthiobuzone, Ftibamzone). Localized ultra violet light and low intensity laser beams are also being used. Steroids have also been suggested for short term use to prevent neuralgia after shingles are gone.

The combined therapy of Western and Traditional Chinese herb therapy is favored in China and is much more effective than just using the modern (western) therapy alone.

Next Page: Traditional Chinese medicine therapy for shingles.