Experience of patients with herpetic ganglioneuritis observation in the neurological hospital

Abstract

Objective — to evaluate the clinical, laboratory and functional parameters of patients with herpetic trigeminal ganglioneuritis in the neurological department. Methods and subjects. The case anamnesis of 43 patients (26 (60.5 %) female and 17 (39.5 %) male) with a diagnosis of herpetic trigeminal ganglioneuritis were retrospectively analyzed: clinical presentation, data on general blood and urine tests, biochemical blood tests, electrocardiography, ultrasound examination of the main arteries of the brain, organs of the abdominal cavity and small pelvis, rheoencephalography. Results. Out of 43 hospitalized patients, 31 (72.1 %) had lesion of the first branch (64.5 % of women and 35.5 % of men), 9 (20.9 %) had lesion of the second branch, and 3 (7.0 %) ) — III branch of the trigeminal nerve. Patients older than 46 years predominated (86.0 %). In general, right‑sided lesion was observed in 22 cases (51.2 %), left‑sided — in 21 (48.8 %) cases. In women, right‑sided lesions prevailed (16 patients — 61.5 %), while in men — left‑sided lesions (11 patients — 64.7 %). The main complaint, in addition to rashes, was local pain, which was mainly of a burning character (24 patients — 55.8 %) with simultaneous itching (15 patients — 34.9 %). Severe pain was observed in 23 (53.5 %), moderate in 14 (32.6 %) and mild in 6 cases (13.9 %). Hyperesthesia accompanied pain in 28 (65.1 %) cases, while only 6 (14.0 %) patients demonstrated hypoesthesia. In the case of involvement of the I branch, herpetic kerato‑uveitis was registered in 9 (29.0 %) cases. Edema of the periocular region was observed in 17 patients (54.8 %). In the case of elderly patients, intellectual and mind functions decrease (45 %), positive subcortical reflexes (46.5 %), and moderate coordination disorders (34.9 %) were observed. Among the general and functional analyses carried out, attention was drawn to an increase ESR (39.5 %), as well as metabolic changes in the myocardium on the ECG (65.1 %). In the case of older age group, comorbidities were dominated by bychronic cerebrovascular accident (45 %), arterial hypertension (40.0 %), type 2 diabetes mellitus (25.0 %), and osteochondrosis (20.0 %). Conclusions. In the case of herpetic lesions, clinical observations confirm the predominant lesion of the I branch of the trigeminal nerve, more marked predominance of elderly women with right‑sided symptoms in the pathological process was observed. Beside the background of typical rashes, severe baking local pain, accompanied by itching and hyperesthesia, dominates in the clinical picture. Despite sometimes delayed hospitalization due to attempts at outpatient or self‑treatment, a general blood analysis often reveals markers of inflammation. The complexity and variability of complaints, as well as examination results, can be mainly explained by the elderly age of patients.