Prevalência de Neuralgia do Trigêmeo em Pacientes com Herpes-zóster em Face: Uma Revisão Sistemática

Abstract

Introduction: Facial herpes zoster, caused by reactivation of the varicella-zoster virus, may lead to postherpetic trigeminal neuralgia (PTN), one of the most painful and disabling complications due to persistent neuropathic pain. Objective: To evaluate, through a systematic review, the prevalence, risk factors, and preventive strategies for PTN in patients with facial herpes zoster, based on evidence published between 2000 and 2025. Methodology: The review was conducted according to PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, and Google Scholar using the descriptors “trigeminal postherpetic neuralgia”, “herpes zoster ophthalmicus”, “facial zoster neuralgia” and “postherpetic neuralgia prevalence”. Systematic reviews, meta-analyses, and observational studies addressing PTN prevalence, risk factors, and clinical outcomes were included. Results: The analysis revealed a prevalence ranging from 20% to 40%, particularly among elderly and immunocompromised patients, with higher risk in cases involving the ophthalmic branch of the trigeminal nerve. Severe acute pain, delayed antiviral therapy, and ocular involvement were associated with chronic pain. Early antiviral treatment and recombinant zoster vaccination proved to be the most effective preventive measures. Conclusion: PTN remains a frequent and disabling complication whose prevention depends on early diagnosis, prompt treatment, and evidence-based preventive strategies to reduce morbidity and improve patients’ quality of life.