Alexander Mason, Kristen Ayres, Sigita Burneikiene, Alan T. Villavicencio, E. Lee Nelson, Sharad Rajpal

“ Then, without an inciting event, approximately 12 months prior to presentation in our office, she was experiencing a paroxysmal, lancing, sharp and painful, stabbing-like pain in the V1 dermatome that was triggered by eating, brushing teeth, and occasionally yawning. A brain MRI was done to rule out multiple sclerosis or structural abnormality. The two different symptom sets, with the former consistent with PHN and the later consistent with TN, were unique to our practice and the literature.
3. Discussion Herpes zoster affects approximately 4 patients/1,000 Americans per year. ”

“ Like PHN, risk for TN increases with age. Incidence was found to increase to 17.5/100,000/year for ages 60–69 and 25.6/100,000/year after age 70 [2] . Although there are many idiopathic cases of TN, it has been found to be comorbid with such disorders as arterial hypertension, Charcot-Marie-Tooth neuropathy, and glossopharyngeal neuralgia [2] . ”

“ Fifty-six percent of patients have thoracic dermatomes affected; up to 25% of patients have cranial trigeminal nerve involvement, most commonly the first division [4] [5] . Pathophysiologically in HZ, varicella zoster virus can become latent, typically in the neuronal cell bodies. ”