Reactivation Of Herpes Simplex Virus After Trigeminal Neuralgia

Objective Primary trigeminal neuralgia(PTN)is one of the most common cranial nerve diseases in clinical practice,which seriously affects patients' life,work and physical and mental health.The etiology and pathogenesis have not yet been clearly determined.The clinical symptoms cannot be fully explained.The investigation of its etiology is still the current hot spot.It is found by clinical observation that some patients will have perioral herpes on the same side after surgery.According to the biological characteristics of herpes simplex virus(HSV),it is considered that the occurrence of herpes may be related to the infection of HSV.Therefore,some experts viewed that herpes simplex viruses is related to the primary trigeminal neuralgia,this view has been paid more and more attention in recent years.In this article,we observed the relationship between primary trigeminal neuralgia and herpes simplex virus and the factors affecting the reactivation of herpes simplex herpes by observing the reactivation of herpes simplex after surgery.Methods Primary trigeminal neuralgia was treated by microvascular decompression(MVD)or partial sensory rhizotomy(PSR).Patients were followed up for 3-12 months.The time of appearance,side and outcome of herpes simplex were closely followed and recorded,retrospective analysis of the relationship between primary trigeminal neuralgia and herpes simplex virus and factors affecting the emergence of herpes simplex.Results Among 91 patients undergoing MVD or PSR,56 cases of perioral herpes appeared 2-3 days after surgery and self-resolved in 7-14 days,and perioral herpes appeared on the affected side.The patient complained of no special feeling,and did not be treated.After statistical analysis,there was no significant difference in gender,age,side,responsible blood vessels,pain distribution range,diabetes and hypertension(P>0.05).Statistical analysis showed that the efficacy of carbamazepine,the length of the preoperative course and surgical methods,the difference were statistically significant(P <0.05).The binary logistic regression analysis indicated that the duration of trigeminal neuralgia was(OR=1.009,95% CI:1.000-1.017;P=0.049)was associated with the appearance of herpes simplex aroundthe mouth;the efficacy of carbamazepine(OR=16.188,95% CI: 1.959-133.802;P=0.010)was associated with the appearance of herpes simplex;the choice of surgical approach(OR=11.094,95% CI:1.304-94.401;P=0.028)correlated with the appearance of herpes simplex.Conclusions Herpes simplex virus plays an important role in the pathogenesis of primary trigeminal neuralgia.The appearance of perioral herpes after trigeminal neuralgia confirms the neurotropic and reactivation characteristics of herpes simplex virus.The longer the preoperative course of trigeminal neuralgia,the greater the likelihood of herpes simplex virus reactivation after surgery;patients who received oral carbamazepine before surgery can inhibit postoperative perioral herpes;Compared with MVD,it is more easier that the emergency of perioral herpes after PSR.