[Clinical course and treatment of herpetic trigeminal ganglionic neuropathy]. / Klinika i lechenie gerpeticheskoi ganglionevropatii]

45 patients were observed in the periods of both acute herpes zoster and postherpetic neuralgia (PHN). In most of the patients herpetic eruptions were located in the areas of innervation of the first branch of the trigeminal nerve. In acute period of the disease there were used aciclovir, helepin or alpisarinum, antiherpetic immunoglobulin, deoxyribonuclease, non-narcotic analgetics were used. Of 28 patients residual PHN was observed in 6 cases, delayed PHN (during 3 months)--in 2 patients. The PHN development was characteristic for elderly patients, delayed request for medical care, concomitant diseases, eruptions with hemorrhagic component and secondary pyodermia and considerable residual sensory deficit. In therapy of PHN the most effective drugs were amitriptylin, non-narcotic analgetics, anticonvulsants as well as acupuncture and electroacupuncture. Relief of a typical deafferentation of pain syndrome was achieved by means of ultrasonic destruction of the trigeminal nucleus (one case). Early therapy of acute herpes zoster does not prevent completely PHN development, but it decreased considerably probability of its forming as well as the severity of its course.

[Pathogenetic mechanisms and neurophysiological diagnosis of trigeminal neuralgia]. / Patogeneticheskie mekhanizmy i neirofiziologicheskaia diagnostika nevralgii troinichnogo nerva.

58 patients with trigeminal nerve neuralgia (TNN) were examined in terms of somatosensory evoked potentials (SSEP). The increase of latence as well as the decrease of contra- and ipsilateral SSEP components amplitude were observed in the interval N13-P45. Either bylateral hypersynchronization or desynchronization of SSEP were observed at affect side of face during TNN paroxismal period. It was believed that both variations of entrance of two currents of impulses which had been caused either by face electrostimulation or by pathological trigeminal irritation in brain cortex. The structural defect of trigeminal radix was considered to be the primary pathogenetic factor which became the cause of constant additional impulsation. The irritation processes became as a result the dominant ones in trigenal system forming in turn the generator of pathological increased irritation in nucleus complex mainly. The conclusion was made that dynamic SSEP investigations promoted to make more precise the damage localization as well as to estimate more objectively trigeminal hypperactivity in patients with TNN.