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History of Neurology: Seminal Citation |

The Pathology of Shingles Head and Campbell's 1900 Monograph

Anne Louise Oaklander, MD, PhD
Arch Neurol. 1999;56(10):1292-1294. doi:10.1001/archneur.56.10.1292.
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Shingles (herpes zoster) and postherpetic neuralgia, a chronic neuropathic pain syndrome that can persist after the shingles lesions heal,1 were studied by eminent neurologists of the 19th century. Autopsy studies were used to establish sensory neural pathways in the peripheral and central nervous systems. More recently, zoster and postherpetic neuralgia have served as models for the study of the pathogenesis and treatment of neuropathic pain. Postherpetic neuralgia has the cardinal clinical features of all neuropathic pain syndromes, including sensory abnormalities, ongoing pain, and allodynia (touch-induced pain). Unlike most other neuropathic pain syndromes, such as trigeminal neuralgia or nerve root compressions, shingles has a well-defined pathogenesis and onset, as well as visible lesions, and is therefore uniquely suitable for study.

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This figure, reproduced from Head and Campbell's 1900 monograph,6is one of the earliest depictions of the sensory dermatomes. It was derived from their observations of the location of shingles lesions in almost 500 patients. They use the abbreviation D (for "dorsal") to refer to the thoracic dermatomes.

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