Abstract
The first division of the trigeminal nerve is the second most common site of acute herpes zoster infection after the thoracic dermatomes. In most patients, the pain of acute herpes zoster precedes the eruption of vesicular rash by 3 to 7 days. The rash has a classic vesicular appearance, making the clinical diagnosis of shingles straightforward in most patients. In some patients, the pain of shingles persists beyond skin lesion healing. This persistent pain is known as postherpetic neuralgia. Treatment of acute herpes zoster involving the trigeminal nerve is aimed at acute pain relief and the prevention of postherpetic neuralgia. The use of stellate ganglion block combined with adjuvant analgesics and adjunctive therapies can usually achieve these goals.
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