Patofisiologi neuralgia pascaherpetika (tinjauan biologi molekuler)

https://doi.org/10.22146/bns.v19i2.69201

Aditya Putra Priyahita(1*), Sekar Satiti(2), Yudiyanta Yudiyanta(3)

(1) KSM Saraf, RSU Wiradadi Husada, Banyumas, Jawa Tengah
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Post-herpetic neuralgia (PHN) is a neuropathic pain syndrome with the character of persistent pain in months to years after the healing of the rash of herpes zoster infection (HZ). PHN is one of the persistent chronic pain problems that can have a severe intensity which greatly disrupts the function and quality of the physical, psychological, and social aspects of the patient and ultimately decreases the quality of life.

PHN has very high symptom variability. This indicates that there are many mechanisms that occur in the pathogenesis of PHN. Based on the variation of the symptoms it causes, there are three main mechanisms that explain the occurrence of PHN: peripheral sensitization, central sensitization, and differentiation.

Peripheral and central sensitization is said to be the main mechanism for the clinical symptoms of hyperalgesia and allodynia experienced by the majority of patients with PHN. While the clinical symptoms of hypesthesia or anesthesia, with or without allodinia based on deafferentiation mechanisms are only found in a small proportion of PHN sufferers. A deeper understanding of the mechanism of the occurrence of PHN is needed as a consideration for therapeutic options to improve the quality of life of patients with PHN.

The purpose of writing this literature review is to review the literature on the molecular pathophysiology of the occurrence of PHN.

 

ABSTRAK

 

Neuralgia pascaherpetika (NPH) adalah sindrom nyeri neuropatik dengan karakter berupa nyeri yang menetap dalam hitungan bulan sampai tahun setelah penyembuhan ruam infeksi herpes zoster (HZ). NPH merupakan salah satu masalah nyeri kronis persisten yang dapat memiliki intensitas berat sehingga sangat mengganggu fungsi dan kualitas fisik, psikologis serta aspek sosial pasien dan akhirnya menurunkan kualitas hidupnya.

NPH memiliki variabilitas gejala yang sangat tinggi. Hal tersebut mengindikasikan adanya banyak mekanisme yang terjadi pada proses patogenesis NPH. Secara garis besar, berdasarkan variasi gejala yang ditimbulkannya, terdapat tiga mekanisme utama yang menjelaskan terjadinya NPH, yaitu: sensitisasi perifer, sensitisasi sentral, dan deafferensiasi.

Sensitisasi perifer dan sentral disebutkan menjadi dasar mekanime utama pada gejala klinis hiperalgesia dan alodinia yang dialami mayoritas pasien dengan NPH. Sementara gejala klinis berupa hipestesia atau anestesia, dengan atau tanpa alodinia yang didasari mekanisme deafferensiasi hanya didapatkan pada sebagian kecil penderita NPH. Pemahaman yang lebih mendalam mengenai mekanisme terjadinya NPH sangat diperlukan sebagai pertimbangan pilihan terapi untuk memperbaiki kualitas hidup pasien dengan NPH.

Tujuan penulisan tinjauan pustaka ini adalah untuk mengkaji literatur tentang patofisiologi molekuler terjadinya NPH.

Keywords


pathophysiology; neuropathy; post-herpetic neuralgia

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DOI: https://doi.org/10.22146/bns.v19i2.69201

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