[54F] Experiencing severe head pain post-shingles diagnosis

Patient Description

A 54-year-old female was recently diagnosed with shingles affecting the eye. She has been experiencing sharp head pain that starts at the top of her head and moves down to the affected eye. This pain has been ongoing for over a week, with episodes occurring every hour and lasting about 5 minutes each. The intensity of the pain is rated as 10 out of 10. The patient also reports a burning sensation and a feeling as if something is running in her head. Blisters around the eye have dried out, leaving the side of the face dark. The patient has completed a course of Valtrex and was instructed to stop using steroid-containing eye drops. She has not been prescribed any specific medications for nerve pain, such as gabapentin or pregabalin. Currently, she is taking oxycodone with Tylenol for pain relief, which has not been effective. The patient has no chronic medical conditions, allergies, or other medications. Her next appointment with the eye doctor is scheduled for later this month.

Arora's Assessment

What might be happening

Based on the information you've provided, it seems that your symptoms are related to shingles, specifically herpes zoster ophthalmicus, which affects the eye. The sharp head pain and burning sensation you're experiencing could be due to nerve irritation or postherpetic neuralgia, a common complication of shingles. This condition can cause persistent pain even after the rash has healed.

Postherpetic Neuralgia: This is a condition where nerve fibers are damaged during a shingles outbreak, leading to persistent pain. It can feel like burning, sharp, or electric shock-like pain.
- Treatment: Typically involves medications specifically for nerve pain, such as gabapentin or pregabalin. Antidepressants or topical treatments like lidocaine patches may also be used.

What you can do

Pain Management: Since over-the-counter pain relievers and oxycodone with Tylenol haven't been effective, consider discussing with your healthcare provider the possibility of starting medications specifically for nerve pain, such as gabapentin or pregabalin.
Eye Care: Continue following any instructions from your eye doctor regarding eye care. It's important to monitor for any changes in vision or increased redness and swelling.
Relaxation Techniques: Stress can sometimes exacerbate pain, so consider trying relaxation techniques such as deep breathing, meditation, or gentle yoga.
Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider. This can help in adjusting your treatment plan effectively.

What you should look out for

Changes in Vision: If you notice any changes in your vision, increased redness, or swelling around the eye, contact your healthcare provider promptly.
Worsening Symptoms: If your pain becomes more severe or you develop new symptoms, seek medical attention.
Follow-Up: Keep your upcoming appointment with your eye doctor on December 17th to ensure proper monitoring and management of your condition.

Remember, it's important to consult with your healthcare provider for a formal diagnosis and treatment plan. If you have any further questions or concerns, feel free to reach out.

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1 mo ago

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