acyclovir and Trigeminal-Neuralgia

Topics: Acyclovir; Adrenal Cortex Hormones; Adult; Baclofen; Calcium Channel Blockers; Carbamazepine; Cervical Vertebrae; Cluster Headache; Drug Therapy, Combination; Ergotamine; Eye Diseases; Facial Pain; Female; Giant Cell Arteritis; Headache; Humans; Lithium; Male; Methysergide; Middle Aged; Osteoarthritis; Otorhinolaryngologic Diseases; Psychotherapy; Psychotropic Drugs; Temporomandibular Joint Dysfunction Syndrome; Trigeminal Neuralgia; Vidarabine

Acyclovir was shown to limit herpes simplex reactivation in a controlled trial to prevent herpes labialis after surgical intervention for trigeminal neuralgia. Of 14 patients receiving acyclovir, unambiguous herpes labialis developed in only one, compared with 12 of 16 in the placebo group.

Topics: Acyclovir; Adult; Aged; Clinical Trials as Topic; Female; Herpes Labialis; Humans; Male; Middle Aged; Placebos; Postoperative Complications; Premedication; Random Allocation; Trigeminal Neuralgia

In a randomised, double-blind, controlled study of the effect of prednisolone on the development of post-herpetic neuralgia 78 patients with herpes zoster whose pain and exanthema had been present for less than 96 h were given 800 mg acyclovir five times daily for 7 days and prednisolone in a total dose of 575 mg, starting with 40 mg daily in the first week and tapering off over the next 2 weeks. 18 (23%) of the patients had post-herpetic neuralgia at 6 months after the acute zoster, 9 (24.3%) having received prednisolone and 9 (22.5%) placebo. The 95% CI for the difference between the placebo and prednisolone groups in the proportion of patients having pain at 6 months was minus 17% to plus 20%. Prednisolone, however, relieved pain for the first 3 days. The 1-2 week interval between admission and reappearance of pain and development of triggered pain seems to be the time needed to establish neuralgia. Once established, the type and intensity of pain remained largely unaltered.

Topics: Acyclovir; Aged; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Female; Follow-Up Studies; Herpes Zoster; Humans; Male; Middle Aged; Prednisolone; Random Allocation; Trigeminal Neuralgia

Topics: Acyclovir; Aged; Drug Therapy, Combination; Facial Paralysis; Humans; Male; Methylprednisolone; Microvascular Decompression Surgery; Nimodipine; Postoperative Complications; Treatment Outcome; Trigeminal Nerve; Trigeminal Neuralgia

Topics: Acyclovir; Aged; Brain Stem; Drug Therapy, Combination; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Neurologic Examination; Pregabalin; Trigeminal Neuralgia; Trigeminal Nucleus, Spinal

Topics: Acyclovir; Antiviral Agents; Encephalitis, Herpes Simplex; Female; Humans; Microvascular Decompression Surgery; Trigeminal Neuralgia

Topics: Acyclovir; Antiviral Agents; Encephalitis, Herpes Simplex; Female; Humans; Microvascular Decompression Surgery; Trigeminal Neuralgia

The authors present the first reported case of herpes simplex encephalitis (HSE) precipitated by trigeminal nerve microvascular decompression (MVD). The presentation of this specific case together with the pathogenesis and management of HSE are discussed, with a relevant literature review. This 29-year-old woman with treatment-resistant trigeminal neuralgia underwent a successful elective MVD of the right trigeminal nerve. She was discharged but was readmitted 1 week postoperatively with clinical signs and symptoms of meningitis. A CSF sample was obtained through lumbar puncture before she was treated initially with ceftriaxone. The polymerase chain reaction test of CSF was later positive for herpes simplex virus Type 1, at which point the patient was switched to a 2-week course of intravenous acyclovir before being discharged. Although this disease is rare, to avoid a delay in antiviral treatment the authors suggest that HSE should be considered in any patient presenting with a meningoencephalitic picture following MVD.

Topics: Acyclovir; Adult; Antiviral Agents; Cerebrospinal Fluid; Electroencephalography; Encephalitis, Herpes Simplex; Female; Herpesvirus 1, Human; Humans; Infusions, Intravenous; Magnetic Resonance Imaging; Microvascular Decompression Surgery; Spinal Puncture; Trigeminal Neuralgia

A patient developed herpes zoster of the maxillary division of the trigeminal nerve after microvascular decompression. Varicella zoster virus lies dormant in the Gasserian ganglion until reactivation and can cause herpes zoster ophthalmicus. This can result in serious ocular complications including blindness. Antiviral agents are effective if commenced promptly.

Topics: Acyclovir; Aged; Antiviral Agents; Decompression, Surgical; Herpes Zoster; Humans; Male; Treatment Outcome; Trigeminal Nerve; Trigeminal Neuralgia

Topics: Acute Disease; Acyclovir; Aged; Anticonvulsants; Antiviral Agents; Carbamazepine; Diagnosis, Differential; Female; Headache; Herpes Zoster; Humans; Oxcarbazepine; Time Factors; Trigeminal Neuralgia; Valacyclovir; Valine

The article reports on 41 patients having infections induced by Herpes simplex and Herpes zoster virus. Systemic intravenous administration of acyclovir results in a very rapid reduction of pain and mucosal changes in herpetic stomatitis. In cutaneous lesions of the trigeminal nerve branches induced by Herpes zoster virus there is also a very rapid reduction of pain and efflurescence after 3 days. In 16 patients suffering from Ramsay Hunt syndrome, also known as Herpes zoster oticus, lesions of the facial nerve function were present. 8 Patients demonstrated cochleovestibular signs and symptoms, 2 had flat inner ear hearing loss of 40 dB, 1 reduced unilateral caloric response. Treatment was effected by intravenous administration of acyclovir and simultaneous classical symptomatic therapy consisting of intravenously administered dextrane, cortisone and antiinflammatory drugs. Symptomatic therapy is necessary because acyclovir stops the replication of viruses but does not influence the disturbed nerve function. In 2 cases with a damage of more than 90% of the facial nerve fibres, endaural decompression of the geniculate ganglion was performed. Cochleovestibular deficits improved to normal during one week and all facial lesions within 8 months. Drug-related side effects were seen in one patient who had an exanthema.

Topics: Acyclovir; Adult; Antibodies, Viral; Female; Herpes Labialis; Herpes Simplex; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Otorhinolaryngologic Diseases; Simplexvirus; Stomatitis, Herpetic; Trigeminal Neuralgia