acyclovir and Sensation-Disorders

The effect of oral treatment with acyclovir (ACV) on sensory axonal neuropathy, segmental motor paresis and postherpetic neuralgia (PHN) was studied in 105 patients with herpes zoster. Forty-seven patients were treated with ACV at a dose of 4 g/day in 5 doses for at least a week; the others did not undergo any kind of treatment. Electrodiagnostic examination of the nerves and muscles corresponding to the dermatomeric lesions was performed, including sensory and motor nerve conduction studies, blink reflex and electromyography (EMG). The patients treated with ACV showed a significant reduction in the number of cases in which there was electrophysiological evidence of axonal damage in afferent fibres of nerves arising from roots corresponding to affected dermatomes. The treated group also showed a smaller incidence of segmental motor neuritis, clinically evident or only detectable by EMG as denervation. However, there was no significant difference between groups as far as the incidence of PHN was concerned. Oral treatment with ACV therefore reduces peripheral sensory axonopathy due to ganglion damage and prevents the possibility of spread to anterior roots and spinal motoneurones. In this way it reduces the incidence of segmental motor neuritis, but does not reduce the incidence of PHN.

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Axons; Blinking; Electromyography; Electrophysiology; Female; H-Reflex; Herpes Zoster; Humans; Incidence; Male; Middle Aged; Neural Conduction; Neuralgia; Paresis; Prospective Studies; Sensation Disorders

Describe the case of an Anterior Cord Syndrome secondary to transverse myelitis. ANTERIOR CORD SYNDROME: Anterior Cord syndrome (ACS) is characterized by a lesion that affects the anterior two thirds of the spinal cord while preserving the posterior columns. TRANSVERSE MYELITIS: Transverse myelitis (TM) is an inflammatory disorder with a heterogeneous pathogenesis affecting the spinal cord at one or more segments, resulting in motor, sensory, and autonomic dysfunction in the absence of a preexisting neurological disease or spinal cord compression.. The patient was treated with methylprednisolone, IV Antibiotics, acyclovir, and inpatient rehabilitation.. The patient significantly improved her function throughout inpatient rehabilitation and was discharged after achieving modified independent level with ambulation and all activities of daily living. The patient also gained independence with an intermittent catheterization program and a nightly bowel program, which included suppository and digital stimulation.. This case illustrates the first documented pediatric patient with a unique case of Anterior Cord Syndrome caused by idiopathic transverse myelitis.

Topics: Activities of Daily Living; Acyclovir; Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antiviral Agents; Autonomic Nervous System Diseases; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Methylprednisolone; Motor Neuron Disease; Myelitis, Transverse; Physical Therapy Modalities; Rehabilitation Nursing; Sensation Disorders; Spinal Cord; Syndrome; Treatment Outcome