Shingles And Stroke

Shingles (dermatomal zoster) is caused by reactivation of latent herpes zoster virus, the agent that causes chicken pox. Risk of shingles increases steadily with age. The most feared complication is postherpetic neuralgia, which can be very severe and intractable.

For years, it has been recognized that activation of the zoster virus affects nerve roots and areas of the spinal cord to cause shingles but, simultaneously, the virus can affect arteries, causing inflammation within the arteries, and this leads to stroke.

A study published in Mayo Clinic Proceedings, December 9, 2015, concluded that people with shingles had increased risk of stroke in the next 3 months but not beyond that.

A new and fascinating finding, not covered in that article, is the fact that the condition termed giant cell arteritis / temporal arteritis, which can cause blindness, may be caused by reactivation of the virus. Patients with this disorder may need steroids for years with attendant adverse effects. It is now recommended that when this disorder is diagnosed patients be put on an antiviral agent such as acyclovir, valacyclovir, or famciclovir concurrently with steroids with the hope that the combined therapy will reduce duration of need for steroids.

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