Herpetic edema

Published in the journal:
Bulletin of Experimental Biology and Medicine, 2006, Appendix 1


L.I. Mnatsakanova, V.M. Kusch
Neurological department of the Central Regional Hospital, Domodedovo

The use of the drug "Mexidol" in the complextherapy of patients with postherpetic facial neuralgia in the acute period contributes to a significant reduction of pain syndrome, improving the emotional state of patients, and reducing the duration of inpatient treatment.

Keywords: mexidol, Gasser's node, postherpetic neuralgia of the facial nerve

One of the most commonneuralgia of the trigeminal and facial nerve) of neurologic pain syndromes, caused by the defeat of cranial nerves, is the Gasserian ganglion node. This pathology is based on the inflammatory lesion of the trigeminal nerve node caused by herpetic infection.

The virus affects the ganglia of the nervous system and remainsin them in an inactive state until the moment of activation, which may be due to a decrease in immunity, malignant neoplasms, the use of immunosuppressants, and also occur as a result of a competitive infection. Acute herpetic infection affects more often the elderly, is a reflection of immunosuppressive changes related to age, often not having a specific cause, and does not depend on sex.

With herpetic ganglionitis of trigeminalnode constant and painful pains precede the appearance of rashes on the 3-5th day. Febrile and general malaise are possible. Pain and eruptions are more often localized in the innervation zone of the first branch of the trigeminal nerve, less often in the second and third branches. In most cases, the lesion is limited to the skin, in the area of ​​the rash develops edema (edema of the eyelids, periorbital edema), possibly involving the cornea (keratitis). Examination of the eye is difficult due to pronounced edema and photophobia.

Ophthalmic herpes can be combined withdefeat of cranial nerves (oculomotor). Treatment should be started as early as possible with the use of antiviral drugs (acyclovir (zovirax) 800 mg 5 times a day for 10 days), antihistamines (locally prescribed ointment - zovirax with interferon, oxoline, tebrofenovuyu).

Postherpetic neuralgia is a frequent complicationGanglionitis Trigeminal Node, occurs in 10% of patients who undergone Gasser's ganglion node. Neuralgic pain can occur one month after the appearance of rashes, in this case it is a question of acute postherpetic neuralgia. Continuing pain for 6 months characterize chronic postherpetic neuralgia.

Pain is noted in the area of ​​the first branchtrigeminal nerve, localized in places affected by herpetic infection, appear after the disappearance of skin manifestations and are of a varied nature (persistent burning, sharp, sudden, shooting). Most patients experience emotional depressive disorders. Treatment of postherpetic neuralgia is extremely difficult and in some cases ineffective.

The purpose of our work was to study the effectiveness of the domestic drug "Mexidol" in the treatment of patients with acute postherpetic neuralgia of the Gasser node.

15 patients with acutepostherpetic neuralgia of the Gasser node (13 women and 2 men aged 58-67 years). Concomitant diseases were hypertension in combination with cerebral atherosclerosis (in 10 patients), ischemic stroke (in one patient in the past), dyscirculatory encephalopathy without acute vascular episodes (in 4 patients). In all cases, a psychoorganic syndrome of a depressive nature was found.

Treatment "Mexidol" was conducted in conditionshospital. The drug was administered in a dose of 4.0 ml intravenously drip for 3 days, then intramuscularly 2.0 ml 2 times a day for 7 days. Two patients "Mexidol" of 2.0 ml were injected by electrophoresis in the most painful points for 5 sessions.

There was a reliable regress of pain syndrome,Depressive disorders disappeared, the length of stay in the hospital was reduced by 2 days (12 calendar days). At discharge, the patients were recommended to take Mexidol tablets on an outpatient basis (0.125 g 3 times a day for 2 weeks) to prevent the development of chronic postherpetic neuralgia.

Thus, after the course of treatment with the drug"Mexidol" state of patients with acute postherpetic neuralgia of the Gasser node is significantly improved due to the effect on the processes of energy production in the cell, the reduction of production of free radicals and the restoration of the activity of antioxidant protection enzymes. Meksidol activates the intracellular synthesis of protein and nucleic acids, the enzymatic processes of the Krebs cycle, promotes the utilization of glucose, the synthesis and intracellular accumulation of ATP, a reduced synthesis of which under conditions of ischemia and hypoxia is the trigger mechanism of pathomorphological changes in nerve cells. The use of the drug "Mexidol", which has a multicomponent antihypoxic, antioxidant, vaso-and reoprotective action, is most suitable in conditions of high probability of development of tissue postischemic disorders. The drug "Mexidol" can be recommended for the treatment of patients with different types of neuralgia / neuropathies.

Its use in the complex therapy of patients withpostherpetic facial neuralgia in the acute period contributes to a significant reduction in the pain syndrome, improving the emotional state of patients, and reducing the duration of inpatient treatment.

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2. Knyazev A.V. Panteleeva M.V. Lobov M.A. and others. Mexidol as a means of neurometabolic protection of the brain during surgical interventions. M. 2005.
3. Oymotkina O.Sh. Lishchuk A.N. Results of clinical study of the effect of the drug "Mexidol" on cerebral circulation in patients with coronary heart disease in the preoperative and postoperative periods. M. 2000.

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Document Date: April 2008