Herpes Simplex Reactivation After Surgical Treatment of Trigeminal Neuralgia: A Retrospective Cohort Study

Berra, Luigi Valentino; Armocida, Daniele; Pesce, Alessandro; Rita, Andrea Di; Santoro, Antonio

doi:10.1016/j.wneu.2019.01.226

Cited by 15 publications

(9 citation statements)

References 28 publications

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“…As this patient had a recent microvascular decompression, procedural manipulation may have led to viral reactivation—promoting CSF HSV-2 PCR positivity. Although previous case series have shown evidence of HSV-1 and varicella zoster reactivation after trigeminal nerve microvascular decompression,13 HSV-2 reactivation has not been previously reported. While a notable finding, it remains unlikely the HSV-2 and related inflammatory changes led to the aneurysmal expansion, as this was most certainly due to angioinvasive fungus.…”

Section: Discussionmentioning

confidence: 72%

Mycotic aneurysm

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Section: Discussionmentioning

confidence: 72%

Mycotic aneurysm

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“…Since Cushing reported herpes zoster reactivation after trigeminal nerve surgery, difficulties are associated with differentiating between herpes simplex and zoster. [ 5 ] Herpes zoster has not been reported in many studies, even those with a large number of patients [ Table 3 ]. Any facial and oral vesicles other than on the vermillion border suggest herpes zoster, the characteristics and clinical course of which differ from those of herpes simplex.…”

Section: Discussionmentioning

confidence: 99%

“…These findings indicated that a minimal stimulation or inapparent trauma to the trigeminal sensory root was sufficient to activate latent HSV. HSV reactivation has since been identified as one of the postoperative complications that develop after various lesioning procedures, including glycerol injection,[ 2 , 3 , 4 , 6 , 16 , 25 ] percutaneous balloon compression,[ 5 , 9 ] surgical and radiofrequency rhizotomy,[ 4 , 8 , 15 ] and MVD. [ 5 , 9 , 15 , 18 ] Although only HSV reactivation has been detected, the symptoms of herpes zoster may be included in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…HSV reactivation has since been identified as one of the postoperative complications that develop after various lesioning procedures, including glycerol injection,[ 2 , 3 , 4 , 6 , 16 , 25 ] percutaneous balloon compression,[ 5 , 9 ] surgical and radiofrequency rhizotomy,[ 4 , 8 , 15 ] and MVD. [ 5 , 9 , 15 , 18 ] Although only HSV reactivation has been detected, the symptoms of herpes zoster may be included in the literature. These clinical features have not yet been clarified in sufficient detail.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of herpes simplex virus reactivation after microvascular decompression for trigeminal neuralgia: Experience of 200 patients and a literature review

Kikuchi

Ishizaki

Yokosako

et al. 2022

Surgical Neurology International

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Background: Herpes simplex virus (HSV) reactivation occasionally develops in the early postoperative period after microvascular decompression (MVD) for trigeminal neuralgia (TN). Therefore, the present study investigated the clinical features of this phenomenon. Methods: The study cohort comprised 200 patients with 125 women aged between 17 and 90 years (median age, 66 years) who underwent MVD for TN between January 2010 and December 2020. Characteristics were compared between patients with and without HSV reactivation and clinical features were analyzed. Results: Twenty patients had HSV reactivation: herpes labialis in 18 and herpes zoster (final diagnosis) in 2. A multivariate analysis revealed independent correlations between postoperative HV reactivation and a previous history of herpes labialis (odds ratios [OR]: 6.32, P = 0.0003) and reoperation for recurrent or persistent pain (OR: 5.06, P = 0.0211). No significant differences were observed in pain relief, postoperative facial numbness, or Barrow Neurological Institute Pain Intensity/Facial Numbness Scores in the past follow-up between patients with and without HSV reactivation. HSV reactivation manifested at a median of the 4th postoperative day (1–10 days) and its location was not related to the preoperative distribution of facial pain. All patients were treated with local acyclovir and were completely cured within 1–2 weeks. Conclusion: HSV reactivation occurred in 10% of patients after MVD including 1% of herpes zoster. A previous history of herpes labialis and reoperation was identified as risk factors for reactivation. Symptoms were completely cured by antiviral drugs within 1–2 weeks. It is important to note that cases of herpes zoster may be confused with cases of HSV after MVD.

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“…The incidence of postoperative perioral herpes is 14.7%, and preventive antiviral therapy may reduce its incidence ( Berra et al, 2019 ).…”

Section: Minimally Invasive Interventional Therapymentioning

confidence: 99%

Chinese expert consensus on minimally invasive interventional treatment of trigeminal neuralgia

Fan

et al. 2022

Front. Mol. Neurosci.

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Background and purposeTrigeminal neuralgia is a common condition that is associated with severe pain, which seriously affects the quality of life of patients. When the efficacy of drugs is not satisfactory or adverse drug reactions cannot be tolerated, minimally invasive interventional therapy has become an important treatment because of its simple operation, low risk, high repeatability and low cost. In recent years, minimally invasive interventional treatments, such as radiofrequency thermocoagulation (RF) of the trigeminal nerve and percutaneous microcompression (PMC), have been widely used in the clinic to relieve severe pain in many patients, however, some related problems remain to be addressed. The Pain Association of the Chinese Medical Association organizes and compiles the consensus of Chinese experts to standardize the development of minimally invasive interventional treatment of trigeminal neuralgia to provide a basis for its clinical promotion and application.Materials and methodsThe Pain Association of the Chinese Medical Association organizes the Chinese experts to compile a consensus. With reference to the evidence-based medicine (OCEBM) system and the actual situation of the profession, the Consensus Development Committee adopts the nominal group method to adjust the recommended level.ResultsPrecise imaging positioning and guidance are the keys to ensuring the efficacy and safety of the procedures. RF and PMC are the most widely performed and effective treatments among minimally invasive interventional treatments for trigeminal neuralgia.ConclusionsThe pain degree of trigeminal neuralgia is severe, and a variety of minimally invasive intervention methods can effectively improve symptoms. Radiofrequency and percutaneous microcompression may be the first choice for minimally invasive interventional therapy.

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Herpes Simplex Reactivation After Surgical Treatment of Trigeminal Neuralgia: A Retrospective Cohort Study

Cited by 15 publications

References 28 publications

Mycotic aneurysm

Mycotic aneurysm

Clinical features of herpes simplex virus reactivation after microvascular decompression for trigeminal neuralgia: Experience of 200 patients and a literature review

Chinese expert consensus on minimally invasive interventional treatment of trigeminal neuralgia

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