Shingles, also known as herpes zoster, is an infection that is caused by a reactivation, often years later, of the chicken pox virus. The most common symptoms are a painful rash and vesicles, or fluid-filled blisters, that erupt along the area of skin supplied by the affected nerves. Still, other less common symptoms and complications can occur with shingles.
Ongoing Pain
Postherpetic neuralgia causes ongoing problems in the nerves affected by shingles after the infection has resolved. It is more frequent with increasing age. Symptoms include pain, numbness, high sensitivity and tingling in the affected area, according to a December 2007 article in the Journal of the American Academy of Dermatology, "Herpes Zoster: Epidemiology, Natural History, and Common Complications" by Dr. Jeffrey M. Weinberg. In addition, the condition is associated with fatigue, weight loss and insomnia. It is typically treated with tricyclic antidepressants, such as amitriptyline; anti-seizure drugs, such as gabapentin; opioids, such as codeine; or topical drugs, such as lidocaine.
Pus and Increased Inflammation
Shingles causes blisters that can than become infected by bacteria. Symptoms of a secondary bacterial infection include increased redness, swelling or pus in the area of the lesions. Treatment involves the addition of antibiotics.
Vision Problems
Several shingles-related eye problems can cause abnormal symptoms. Herpes zoster ophthalmicus occurs when the virus affects a nerve in the head known as the trigeminal nerve, or cranial nerve V, which serves the eye. The infection can damage the cornea, which is the covering of the eye; the iris, which is the colored ring of the eye; or the eyelids. Doctors typically treat these problems with antivirals and topical steroids.
In the condition known as acute retinal necrosis, the infection damages vision. This occurs weeks to months after the infection, and in more than half the cases, both eyes are affected, according to a 2002 article in "The Journal of Infectious Diseases." In normal patients, it usually leads to some vision loss, but for patients with poor immune system function, it can lead to blindness. Treatment with antivirals decreases the incidence.
Movement Problems
The shingles virus typically affects sensory nerves, causing pain. However, in rare cases, it also affects motor nerves, leading to weakness or an inability to move the affected part of the body. An extreme case would be the condition called delayed contralateral hemiparesis, which occurs an average of seven weeks after infection of the trigeminal nerve. Symptoms include headaches and an inability to move one side of the body.
Brain Infections
The shingles virus can infect the lining of the brain, a condition known as meningitis, or the brain itself, encephalitis. These are seen nearly exclusively in patients with compromised immune systems, such as those taking immune suppressant medications after a transplant or AIDs patients. These infections can cause disorientation, confusion, headache, fever, numbness, movement problems and trouble speaking.
References
- Journal of the American Academy of Dermatology; "Herpes Zoster: Epidemiology, Natural History, and Common Complications"; Dr. Jeffrey M. Weinberg; December 2007
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci; 17th Ed. 2008
- The Journal of Infectious Diseases; "Varicella-Zoster Virus: Atypical Presentations and Unusual Complications"; John W. Gnann Jr.; October 2002
