Use of the Rydel-Seiffer graduated tuning fork in the assessment of vibration threshold in postherpetic neuralgia patients and healthy controls.

Background And Aims: Afferent large fibre impairment has been reported as a useful predictor of postherpetic neuralgia (PHN) in patients with acute herpes zoster infection, using an electromechanical device to provide quantitative vibrametry. We aimed to demonstrate a clinically significant increase in vibration threshold in individuals with PHN compared to age-matched controls, using the portable and affordable Rydel-Seiffer graduated tuning fork.

Methods: We studied 45 PHN subjects aged over 55 years, and 45 age-matched controls with no history of herpes zoster infection.

Management of herpes zoster (shingles) and postherpetic neuralgia.

Herpes zoster (HZ) results from recrudescence of varicella zoster virus latent since primary infection (varicella). The overall incidence of HZ is approximately 3/1000 of the population per year rising to 10/1000 per year by 80 years of age. Approximately 50% of individuals reaching 90 years of age will have had HZ.