Complex treatment of herpetic lesions of the peripheral nervous system Psychosomatic causes of herpes Herpes nerve damage


Herpetic infection is widened in the middle of the population. The first contact, from viruses, herpes develops in early childhood. Already 3 rocks 70-90% of children may have antibodies to herpes simplex virus.

Classification. By localization, you can see:

1) lesion of the central nervous system (encephalitis, meningit, malit);

2) lesion of the peripheral nervous system (ganglioneuritis);

3) after the improvement of the central and peripheral nervous system;

4) the improvement of the nervous system and other organs.

Herpetic encephalitis. Overlap up to one of the most common and most common forms of viral encephalitis. Become a step-by-step stretching out to the rock. Most often get sick with herpes simplex virus type 1. Herpes virus type 2 є encephalitis in newborns, moreover, the infected one resembles mothers with an active form of genital herpes. More often than not, generalized form of infection, if the brain is damaged, is the symptoms of liver damage, legen, pericardium. Mossy development of becoming ill with an infection with an operative herpes virus (herpes virus type 3). Virus herpes є dermato-and neurotropic. The entrance gates are shkіra and muffled shells. In the middle of the disease, there is a proliferation of viruses, wineries, and midwives of the spines of the spiky ball of shkiri. Nadal insists on the virus, the staff of the plant grows in the growing organisms of the tissue, and also to the liver and the central nervous system. In addition, the virus on the nerve ends has been consumed to the nerve ganglia, de persistent rock. Morphologically, encephalitis is a necrotic process with a change in the localization of damage in the medical part of the skinny parts. Near the zones of necrosis, the middle of the ignition reaction is prevented.

Zagvoryuvannya razvivaetsya gosstro, with a sharp increase in temperature, feverish, headache. Meningeal syndrome of bends around. Characteristic is the appearance at the early stage of focal or generalized repeated suicide attacks. Shvidko develops the deterioration of svidomosty, doubtfulness transforms into sopor and coma. Vinnikє is an average neurological symptomatology, which is connected with the reduction of the frontal and frontal parts. Smelling and savoring hallucinations, anosmia, behavior damage, memory disorder, aphasia, hemiparesis are promoted. Mossy development of intracranial hypertension. Without addiction, lethal end is infused in 50–70% of cases. If the cause of encephalitis is the virus of operative herpes, then it is more hospitable. Comatose stun is rare. Clinically, encephalitis is manifested by zagalno-infectious, zagalomoskovy and serendipitous symptoms. Dosage often occurs stovburovі, cerebral syndrome. In liquor, there is an intimidation of lymphocytic pleocytosis (50-100 1 mm 3), it moves in the place of the bottle. On the electroencephalogram, at the same dysrhythmia, there is a widespread activity, as well as periodical high-frequency symptoms.

Herpetic meningit, viklikany virus herpes simplex, may not be supervised by the mucous membranes and shkiri. Ridko come across from the swirling signs of respiratory illness. The temperature of the thylum will not perevychay 375 ° С. Skillful until a protracted leak. Often there is a dissociation of the pelvic syndrome, if the rigidity of the mucous membranes is overloaded with insignificant Kernig symptoms. Meningitis, herpes viral infections, which are operative, often with more severe symptoms. Often, supervising the shkiri, scho viniku on the 4-5th day, I deprive it of development, scho operizu. The temperature is adjusted to 38–39 ° С, a thin head beats, more blues. Virazheni obolonkovy symptoms, to endure often restructuring mid-neurologic symptomatology. In case of lumbar puncture, the solution is without barn, foresight, the vice of movement up to 250-300 mm of water. Art. Lymphocytic pleocytosis, vm_st bilka, normal glucose.

Ganglioneuritis in case of an infection with an operative herpes virus, it is necessary to recover from an infectious disease - due to an increase in the temperature of a sickness, an underlying weakness, a lack of durability. Through a number of days, intense pains, paresthesias in the area of ​​one or some segments occur. Mainly 1-2 sums of spinal ganglia are achieved. Most often the thoracic segments are guarded, followed by the perch of the tricky nerve of the shiiny segments. The differences in localization are even more difficult. After a few days, there is a pain syndrome on the skin and mucous membranes on the papules, and then on the vesicles, papules become serous. Visipannya prodovzhuyutsya stretching for several years. Smell roztashovuyutsya stretching one abo dec_lkoh shk_rnyh segments. When the first part of the tricycle nerve is detected, it is possible to switch the pathological process to the horn, which can lead to a permanent damage to the brain. Hanging bears the character of a "belt" on tulubs or late smogs on kintzivkas. There can be more damage to a large university (Ramsay Hunt syndrome), for which is characteristic of a decrease in the VII and VIII pairs of cranial nerves, hanging in the area of ​​the outer ear canal and in the shell. Proceedingly, the bulbs go out, the skins become pretentious, as they come in, and there is still some pigmentation in their miscellaneous. Often the neuralgic pains do not get to know the symptoms of the symptoms, but they can do it. It is characterized as unbearable baking, how to do it with a dot to the level of dileanok shkiri.

Diagnostics. The order іf given the anamnesis, the scars of the ailment and the objectival clinical picture of the sickness is the complex of laboratory and instrumental methods of preliminaries. In case of adolescence on meningoencephalitis, obovazkovym є carrying out a lumbar puncture, with such a symptom of the firing process may appear. By informative methods of diagnostics є computer diagnostics and magnetic resonance tomography, even at the early stage of the disease, it is possible to develop firing snakes, swellings, midstreams of other hemorrhages in the skinny areas and foreheads. The appearance of the dylyanoks of a decrease in proficiency allows the creation of visnovoks about the necrotic nature of the process. In the development of the peripheral nervous system, it is ligamentous є the conduction of electroneuromyographic dosage, as it allows the development of the potential of fasciculations, the reduction of the speed of the conduction of loose and sensitive fibers. Requirements for laboratory pre-screening of blood samples and liquor. It is important to choose the methods of amplification of nucleic acids - IASC ( polymerase lantsyugov reaction (PLR) and PLR in real time ) ... It is possible to detect specific antigens, vicious reaction of direct immunofluorescence (PIF) and enzyme-linked immunosorbent assay (IPA). Also, with the help of the IFA, there are specific antibodies YgM and YgG and Avidity index YgG.

Likuvannya. Likuvannya is complex. Vibor drug for an hour of etiotropic therapy є anti-tartar drug acyclovir (zovirax). Vibirkovo drug for DNA virus, suitable for synthesis. In mild cases, the drug is prescribed internally at 200 mg 5 times for additional 5 days or internally 400 mg 3 times a day for 5-7 days. You can vikoristovuvati famciclovir internal 250 mg 3 times a day 5-7 days or valacyclovir internal 500 mg 2 times for 5-10 days. In case of a severe interruption of illness, acyclovir should be used internally in drops of skin for 8 years at an additional dose of 30-45 mg / kg. The triviality of the drink becomes 10-14 days. Another highly effective drug recommended for the treatment of herpetic meningoencephalitis is є vidarabin. In some cases, a combination of drugs was used: acyclovir was injected at 35 mg / kg 3 times per day every other day, vidarabin - at 15 mg / kg 2 times per day every other day. You can combine the combination of acyclovir with interferon and interferon inducers. In addition, it is more important to rely on pathogenetic and symptomatic therapy, which is directly related to the prevention and loss of the brain, the adjustment of the water-salt balance to the body, the loss of epileptic syndrome, pain.


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People develop 8 types of herpetic infections, and the symptoms in older viruses are not similar to each other. The range is indicative of herpes as a common type - so called. "Cold" - to psychiatric and oncological illnesses.

Symptoms of herpes type 1 - virus, wiklikє "I'll get cold"

Herpes of the 1st type is the most common virus, which can be easily adjusted. In the main infection, it is found in the nerve endings shyny viddilu a ridge in a jagged viglyad, albeit with low immunity, or in the face of increased stress, it becomes more active and manifests itself with the following symptoms:

  1. A collection of chervonin shkіra and s'verbіzh.
  2. After 6-48 years, one or more vesicles - a bulb, in the middle of a є gap of a ridin - will form on the fired time.
  3. During the duration of the visit, the vesicles burst, expanding to the extent of the information about the day and the viciousness of the growing area of ​​the school.
  4. At the center of the bulb, which burst, there is a wound, which can then be tightened with a scorch.
  5. For the training of the immune system of the ailment, step by step I know "zinak" - to go over to the side of the camp. Without a pidtrimka - all the big dies will get pocky, the wounds are not normally happy.

For the manifestation of symptoms, people can infect people who are sick through contact. Most often herpes 1 is localized on the face of a slimy company. Win can stick lips, cheeks, podborids, mucous nose, eyes, mouthparts or larynx. Infectious infestation on the tulub's shkiru, widening ailments and tilo.

Symptoms of herpes type 2 - genital form virus

The symptomatology of herpes type 2 is similar to type 1, prote localization in bulbs. In the spitting station, the virus is found in the nerve ends of the crisis. Vesicles are established in the main in the pakhvinn_y zone, on the stegna, s_dnitsy, in the area of ​​the anal opening and statute organs.

To add to the acute symptomatology, the deterioration of the mood of that mental state, the loss of appetite, signs of intoxication is caused. Possibility of growing lymph universities near pakhvinny dilyantsi. In females, vesicles can be found in the middle of the uterus, in choloviks - in the urethra.

Uwaga! Most of the recurrence of the other one is trapped for a long time, if the breadth of the others is widespread. In the middle of the onset of immunity, the symptoms go through 2-3 times.

Symptoms of herpes type 3 - virus Zoster

The herpes virus Zoster tends to become infected even in children, and to manifest itself in the vigilantes of the childish vitriol. If the child is wooing, at the end of the tripartite nerve there will be an infection, well, the truth is, it doesn’t show itself in the normal minds of life.

If immunity falls, lyudin's ailment at the GRZ, or just living unhealthy, the symptoms of ailment manifest themselves again. Most of the time it is trapped in people over 50 years, with a recurrence of this type of herpes - nayridkisnish ​​(spostering deprivation in 5% of patients).

Repeatedly falling ill is called an operative lichen and such signs:

As a rule, zhvoryuvannya pass through 1-3 times. When you show up, you will be replaced by sverbezh. In some cases, the soreness does not pass by, the stench subside, the ale appears as a stretch of life.

Symptoms of herpes type 4 - mononucleosis from the Epstein-Barr virus

Virus Epshtein-Barr wikklikє become ill, which is called infectious mononucleosis. The ailment is not safe to eat and the disease is not safe, and the inheritance is not too bad for nondesirable inheritances - the genital malformations in women, blood clotting, oncological pathologies (type of lymphoma), autoimmune disease that chronic vtomy syndrome.

When infected with a herpes type 4 herpes virus, after 7-14 dib, the following symptoms are observed:

A person who is sick often wants to drink, to fever him for about a decade. Lymph nodes change over the course of a month, blood snakes May trimatis up to 6 months. It is not correct to bring up to the old age of immunity, its appearance - to the chronic form of sickness:

  1. Erase- myazov pains, aches in the slopes, frequent low-grade fever, stomachache.
  2. Atipov- parts of the recurrence of infectious ailments (GRZ, illnesses of the SHKT or sechostatic system).
  3. Actively- specific mononucleosis symptoms accelerate with herpetic visips, fungal and bacterial infections. Much more mucus in the intestinal tract, dyspepsia.
  4. Generalizovane- severe damage to the central nervous system, including meningitis, encephalitis, radiculoneuritis. Disorders of myocarditis, hepatitis and pneumonitis.

The symptomatology of chronic infection of Epstein-Barr manifests itself in a rather sickly manner - the number and intensity of signs is gradually growing and gradually changing as a result of the immune system.

Symptoms of herpes type 5 - cytomegalovirus infection (CMV)

Cytomegalovirus does not manifest itself immediately upon infection, but infection is often unaware of its encampment. With the disease immune system, you may not go into the active phase, but simply asymptomatic sleep in the body until the end of life (in 90% of patients, it is so and it appears). Protect lyudin prodovzhuvatime transmit the virus to other people.

Patients who may have symptoms of CMV are most likely to skimp on signs of GDI and mononucleosis (fever, vom, headache, chills), and will be diagnosed 20-60 days after they are infected. The triviality of ailments is important - 4-6 types. The activity of the virus is caused by immunodeficiency, pleurisy, pneumonia, arthritis, encephalitis and myocarditis can occur. Vegetative growth is promoted.

In the generalized form of CMV wikklica, the control of all organisms is the firing of tissue internal organs, eyes, brain, as well as parallich. In choloviks, there is a lot of tissue tissue and urethra, in females, it is fired at any erosion on the uterus, matts, pikhv, or yaunniks, bile-blakytny vidilennya.

Symptoms of small forms of herpes virus 6, 7 and 8 type

Herpes type 6 live in microphages and lymphocytes. In the midst of grown-up people, close to 50% - no infection, which infects the sieve through the roof of the sludge, as well as the occasional-speckled path.

Symptoms of sickness - sverblyach і slizova, feverish woman, gnіyniki abnormally on the backs of the back, breasts or abdomen (exanthemi), mononucleosis syndrome, asthenia. For immunodeficiency mossy encephalitis.

Often, infection occurs in small children (3 months - 4 rocks). Vona is manifested by raptus exanthema and fever (up to 40 ° C), signs of intoxication. Symptoms can be trimmed up to 4 dB, then it will be replaced by 3 days. In some cases, a feverish person is not vicious, but she can be judged through a higher temperature. Upon reaching 5 births, most children develop immunity against herpes type 6, a relapse can cause a particularly strong immune deficiency.

Herpes type 7 With the activation of virus type 6 and the development of chronic autonomic syndrome. Cei syndrome - і head manifestation viral infections.

Vin is manifested by the following symptoms:

  • zagalny zanalya of forces;
  • post-vtoma and visibility of tone;
  • foul moods, anxiety and psychomotional re-entanglement;
  • the loss of propriety and concentration of respect;
  • the appearance of positive changes in the message for a trivial result;
  • razlad memory;
  • headaches and crying;
  • collapsed sleep and lack of sleep in case of tricky sleep;
  • signs of depression;
  • slightly adjustable temperature for a trivial hour (until pivroku);
  • improvement of lymph universities.

Respect Varto! When staging a diagnosis of these symptoms, the specialist needs to differentiate between psychiatric / nervous pathologies, HIV infections, oncological ailments, anemia and impairment of thyroid function.

Herpes type 8 vivcheniya is the best. Prior to these symptoms, the development of the first ailments - Kapos' sarcoma, primary lymphoids, Castleman's ailments and many diseases - must be borne. At the same time, the patient has a malignant new solution on the skin, mucus, internal organs and lymph nodes, where they look like symmetrical plaques with a dark red chi and violet colorah. You can also have a crooked cough, severe dyspepsia, or more during implantation.

Symptoms of full-time herpes, whether type

Ophthalmic herpes develops on the eyes, mucous eyes. Recurrence can be nourished 3-5 times per pik - at least one of the most common forms of herpetic infection, but in the main one is affected by 1 or 3 types of virus.

Symptoms of full-time herpes are similar to allergic or bacterial infections, herpetic vesicles appear on the eyes, and such signs are also diagnosed:

  • ochni apple and povіki chervonyut;
  • vinikak bil that pochuttya, nibi in tsi є sided tilo;
  • with good visibility, discomfort is observed;
  • gostrota zoru padaє, become "clouded";
  • before the eyes are visible spikes chi spalakh;
  • the shape and size of objects are created incorrectly or doubled;
  • the daydream of the sutta fall;
  • blepharospasm - convulsions are cramped.

Often, the patient skars for strong pains in the eyebrow. Pole zoru sta vzhe, in the center there can be a slip plyama. Ruhati ochima is very important. All the same, suprovodzhuvatisya nudota, low-grade fever and headaches.

Symptoms of herpes sore throat

In older children and children, who may be infected with herpes in their bodies, angina is not often susceptible to sickness and infection. Ї ear sprinkle і small і gostry:

  1. Temperatures move up to 40-41 ° C, as with pneumonia.
  2. There are strong pains in the jacket, the pain is even more important, the discomfort is trimmed for 3 days.
  3. The mucous membrane of the pharynx grows swollen, on the winks and the sky can be seen from the bulbs.
  4. The vesicles get angry with themselves for an hour, making a splash "nalit", covering them with water and oozing.
  5. The suppuration of the visceration is limited to 3 types, with a stretch of herpes you can go to the shkiru of exposure.

Incubation period of herpetic angina is trivial 1-2. It’s easy to get sick of some ailments - it’s easy to get intoxication until the vesicles hang for 6 dB, and it’s worth saying goodbye. In some cases there is an accelerated rate - herpetic rhinitis, chronic tonsillitis, otitis media, myocarditis, encephalitis and in.

Symptoms of herpes on internal organs

Internal herpes is manifested by extreme symptoms of those who become ill, splinters of wines and symptoms. The most visible signs of herpesvirus itself do not become susceptible, because of the type of infection it is possible only for clinical preliminaries and laboratory analyzes.

As a rule, during the twisting of stravohods through herpes, lyudin hangs up and suffers from pain in the breastbone and when it is cocked. Likar can go up and down through endoscopic access. Pneumonia, bronchitis and tracheitis with characteristic symptoms (fever, cough, dullness) appear through special analyzes for herpes type 1, often ailments are supressed by fungal and bacterial infections.

Even if the patient has herpetic hepatitis, the symptoms will be similar to those in hepatitis B, or C - zhovtyanitsya, a change in the color of the cut and viporozhnen, the temperature is increased. To find out the reasons for the disease, the patient should be given an analysis for herpesvirus. І so for any damage to internal organs - near the specific symptomatology of the virus is mute.

Symptoms of postherpetic neuralgia

Postherpetic neuralgia - the whole process of getting sick because of herpes type 3. If the patient has a relapse of the virus Zoster, he will feel discomfort and symptoms of infection, if the ailment is already “sick”. The symptoms are getting better. So, for such neuralgia they say:

  • surplus hanging and peeling skins on mints, de buv;
  • pulsating beel or pokryuvannya at tsy galuzi, only in the region is strong;
  • sverblyachka mіzh big attacks, scho wiklikє razdratuvannya, as soon as possible, the offensive beel;
  • onіmіnnya shkіrnіh dіlyanok on mіstі colishnogo deprive or a strong reaction to invitations;
  • the weakness of the paralytic (often in the summer).

Zvychay postherpetic neuralgia is trivial 2-3 months, but only in 2 months or so. Deyakі symptoms take place even better, for example, the meat is weakness and the strong reaction of the shkіri. All the same to the normal way of life of people, as they have transferred the repeated activity of the virus.

One of the reasons for the development of intercostal neuralgia is the herpes simplex virus. The ailment is characterized by a firing process in the nerve endings and plump vispans on the back of the affected nerve. So it’s getting sick of supravodzhuyut constantly strong pains, how to wick the stressful camp of people, waste appetite, how to provoke sleeplessness and reduce people's activity.

Causes of herpetic intercostal neuralgia

The development of such a pathology provoking the activation of the virus varicella-zoster - the virus of vitrianoisp (transverse herpes). With a decrease in the power of human organisms, the pathogenic virus penetrates into the nerves of the university, the nerves of the cells, and they are rapidly shifted by the nerve fibers. Such a pathological process is repaired from the ridge, the spinal nerve is hardened, localized on the right side of the people. Shkirnі visipannya is formed in the process of nerves, suffering from herpes.

Most often herpetic neuralgia is diagnosed in people over 40 years old. The development of ill-health among children and children is fixed in 10% of children.

Virus activates and natomit weak immunity.

Prior to the main reasons for the diagnosis of intercostal neuralgia caused by the herpes virus, there are:

  • weakening of the immune system and people;
  • stronger hypothermia to the body;
  • transfer of GDVI, flu:
  • psychological overstrain.

Symptoms and symptoms

Symptoms of ill health develop in stages:

  1. The cob stage of the diagnosis of such a pathology is characterized by the appearance of the corn and the sverblyachki in the region breast tissue mіzh ribs. Shkіrny curvature near the affected nerves nіmіє.
  2. Severe pain syndrome develops. Pains on the nerves of the middle-aged dilyants will cope with ruins, dots, chkhanna, cold, and may come back to the shoulder dilyanka. Sick seeming can be busty, but crush an arrowy or stupid character.
  3. On skіrі in mіzhrebernіy dіlyantsі, there are puhirtsevі visipannya, reminiscent of the insight of rіdina. Herpes visip expands, shkіra navkolo bulbashok nabryak, ignite. Bil and sverbіzh agree.
  4. Pukhirtsi hang, їkh surface to be covered with skorinki zhovto-brown color. Intermediate nerves are strongly teased and sensitive to the point. In the area of ​​ear nerve cells, there are persistent pains.

On the development of ailments, there are:

  • weakness of the pictures;
  • head b_l;
  • the change of the psychological camp;
  • p_advischennya arterial vise;
  • sleeplessness;
  • waste of appetite;
  • temperature adjustment;
  • heart beat.

The taste of ailments can be posed to the brain.

In case of herpes simplex, the structure of nerve fibers, the sore seems to be pushing the turbulence of a person with a stretch of decimals. Before inherited herpetic neuralgia:

  • training of the nervous system and people;
  • development of meningoencephalitis;
  • neurological syndrome;
  • cover neuropathy.

Diagnostics and treatment

Diagnostics of ailments runtutsya on characteristic manifestations and signs of ailment. To be carried out:

  • zovnishniy look around the sick;
  • laboratory analyzes of blood and blood.

For an accurate differentiation of pathology, it is presumed to be:

  • Ultrasound of internal organs;
  • ridge x-ray;
  • electrocardiogram.

Drug therapy

Likuvalny come to us before directing to the usunennya virus.

The main goals of drug therapy are to eliminate the herpes virus and reduce the pain syndrome. For tsyo vikoristovuyutsya:

  • hormonal intake;
  • anticonvulsant;
  • antidepressant;
  • medical anesthetics;
  • vitamіnnі complexes

For fighting with herpes virus, medications for herpes are shown in the tables:

MedicationLikuvalna diya
"Acyclovir"Likvidu virus to herpes
"Gabapentin"Kupuє interstitial pain syndrome, zapobigak visipu
"Famvir"Help the symptoms of neuralgia, quickly and triviality
"Valtrex"Infectious diseases
DiclofenacKnowledge zapalennya
"Ibuprofen"I lower the temperature of thila, in the sun
"Sidasen"Calm down the central nervous system, sleepy
"Amіtrіptіlіn"Drive pain relief
Plastir "Versatis"Znebolyuє
DexamethasoneRepair the fire and immunosuppressive effects
Vitamin group VRenewal of authority to organisms

With the treatment of herpetic neuralgia in the middle of the disease, there is an effective disease of pain in the field of physiotherapeutic procedures and golkoreflexotherapy.

3
1 FDBOU U Saratov DMU im. V.I. Rozumovsky Ministry of Health of Russia
2 FDBOU VO “Saratov DMU IM. V.I. Rozumovskiy "Ministry of Health of the Russian Federation
3 State Budgetary Educational Institution of Higher Professional Education “Saratov DMU IM. V.I. Rozumovskiy "Ministry of Health of Russia, Saratov


For a quote: Igonina I.A., Dzvoniv O.V., Bakulov A.L., Kravchenya S.S., Dzvoniv A.M., Sitkali I.V. Complex treatment of herpetic lesions of the peripheral nervous system // RMZ. 2013. No. 30. S. 1518

Shingles (herpes zoster) is a disease that is infected with herpes virus type 3, which is based on the reactivation of latent ganglion-associated virus infections. In typical cases, operative herpes is manifested by feverishness, we are sick with bulbous viscera on shkіrі, roztasovany along the nerves.

Potency for operational lichens varies from 0.4 to 1.6 per 1,000 individuals - from up to 20 years and from 4.5 to 11.8 per 1,000 individuals - from more senior groups. Choloviks and women are ill with the same frequency. Prior to important factors in the development of herpes zoster, they endure stress, hypothermia and physical trauma. Decreased incapacitation of a large number of children in the summer, due to the manifestation of supportive autoimmune, oncological and hematological pathologies, red diabetes Acceptance of immunosuppressive drugs (corticosteroids, cytostatics) VIL-infection is unpleasantly infused into the development of the disease, as well as on the stage of severe dermatosis. So, the incidence of operatively relieved from 20 to 50 years in VIL-informed people, 8 times, changed from 20 to 50 in immunocompetent individuals. Relapse of the ailment occurs less in 5% of the ailment.
An outstanding feature of the pathogenic fever of herpes zoster - Varicella zoster virus (VZV) from the ancestor of the Alphaherpesvirinae family Herpesviridae - є the health of persistence in the sensory ganglia of such reactive ganglia As of the day, there are two key forms of disease, wickedness with one and the same ethiotropic agent. Dermatosis manifestus from the primary infection - vitriol, then pass into the latent phase from localization in the ganglia of the posterior roots of the spinal cord and ganglia of the cranial nerves, recurrent in most of the year.
Shlyakh transmission Varicella zoster virus The replication of viruses on the mucous membranes of the dichloro wards goes through migration to lymphatic universities and CD4 + lymphocytes, as well as to epithelial cells. The information of the end of sensitive nerves is preceded by a late virus, which є at the majesty of the vesicles on the nipples. Further, the VZV widening in macroorganism can be hematogenous, lymphogenous and neurogenic (behind the axons of sensitive nerves) paths. Virus of the sensory ganglion of the nervous system, which will prevent any pre-existing persistence in the body of people. Products activate a number of virus genes before blocking interferon, decreasing the expression of a number of receptors on immunocompetent cells, as a result of which VZV builds up the health of "vislysis" in the mechanisms of human immune systems.
Reducing the tension of cell reactions will lead to the reactivation of the virus, so that it’s supervised to hit it, but it’s the end of the nerve. Histologically, when the virus is reactivated in the ganglia, blood is revealed, and lymphocytic infiltration is inflated with a stretching of the sensitive nerve. The nature of the cycle of changes is the manifestation of those stages of the variability of the pain syndrome.
Most dermatovenerologists detect the appearance of the onset of clinical forms of operative lichen: vesicular, without visipus (zoster sine herpete), generalized, deseminovan, mucous membranes, ophthalmic herpes, Hant's syndrome, abdominal disease, and also
According to the localization, the rate of the trigeminal (gasser) and the number of universities, shinnyh, chest and transverse kryzhovy ganglia is seen. On the thought of a large number of females, most often children are afraid of spinal and tripartite nerves, and most often, before a pathological process, thoracic dermatomy occurs. For a number of authors, it is herpetic to develop a Gasser university more often, less spinal ganglion.
Call me sick manifest with pain syndrome. Closely 70-80% of patients with operative lichen in the prodromal period present scarg for more in the affected dermatome, in the zone where the disease is associated with shingles.
The prodromal period may have a permanent or attack-like character. Most often it is described as a baking, firing, prickly or pulsating. Deyakі ailments see more deprived with a dot. In іnshikh patients, a provincial clinical symptom є bends of the shkiri sverbіzh. The prodromal period is trivial 2-3 days, ale inodi syagak tyzhnya.
Neridki paresthesia in urazheniye dilyanka. The intensity of the pain syndrome begins with the level of peripheral nerve learning in the pathological process. In 2-7 days on the shkіrі they will repair the types for depriving, operіzu, visipannya. In the most classic one, herpes zoster is a tense ephemeral erythema, nabryak, instead of many papules, which quickly transform into vesicles in 2-3 days. Efflorescences are strong to the point of being angry and angry. Occasionally, the second pituitary infection is associated with pustules in the midsection.
Variations of infectious diseases manifest (hot, cephalgia, malgia, stomachache, distant neoplasm), as well as the improvement of regional lymphatic universities, are less expensive in 20%
For a number of authors, with pre-cerebrospinal birth in case of deprivation, operatively, lymphocytic pleocytosis appears.
After 3-5 days on the vesicle mass there are erosions and skorinki appear, which can be known up to 3-4 times. On the occasion of the visipan, it was allowed, you will be able to get the hypo-abo hyperpigmentation. Whenever new vesicles appear more than 1 period, it will take a high degree of visibility in a patient with immunodeficiency. On the mucous membranes, the skorinoks are replaced by negligible erosions. Hanging on the mucus can become uncomfortable.
It is important that, in case of herpes, it is operative, the widening of the pathological process appears to the singing dermatoma on one side of the body (either right or right) and does not overtake the anatomical middle line of the tulub, behind the wine zones of the wrinkle. Immunocompetent patients develop one dermatome, protea through the individual variability of the innervations in the process can be obtained from susceptible dermatomes.
Visipannya call me super great views, as in the prodromal period. However, in some cases, the pain syndrome can be deprived of the state of the art period.
In case of abortive form herpes zoster, hanging on the skirts is surrounded by erythema and papules, without transformation in empty elements. In case of hemorrhagic form of operative lichen in the place of vesicles, hemorrhagic hemorrhagic, pathological process is not only epidermis, but the dermis, if scars are allowed to be visibly established. From the most common types of herpes zoster, they see a necrotic and deseminated form of lichen operculum.
As a rule, it has an intense baking character, a zone of widening evoked the roots of a severe ganglion. Call me to accommodate myself at night with the inflow of different kinds of pets (tactile, temperature, etc.).
With an active look, there may be some changes in sensitivity, such as hyperesthesia, hyposthesis or anesthesia, including anesthesia dolorosa, and others. Razladny sensitiveness, wake up between the area of ​​visipan, protest even less for the form and intensity.
The stage of the development of pain syndrome is due to the severity of the symptoms. In a number of ailments, the gangrenous form of the attack of the shkiri is unimportant to the importance of becoming insignificant and short-lived. At that very hour in their children, a trivial intense pain syndrome is observed for the minimal malaise.
With ganglionitis of a gasser university, there are more pains, impairment of sensitiveness and hanging in the zone of innervation of one (I, II or III), two (rather) all gilts of the threefold nerve. In case of ophthalmic herpes, keratitis, episcleritis, iridocyclitis, in some cases - lesions of the mucous membrane of the eye, optic neuritis with a trace of atrophy of the healthy nerve, as well as glaucoma. It is possible to cut the III, IV, VI cranial nerves, which can be manifested by okorukhovy breaks and ptosis.
Infection, when VZV is infected with herpes simplex virus - Herpes simplex virus (HSV) - the most common cause of Bell's paralysis, shkirnі show at the same time, it can be external, and the ethological role of VZV, or HSV, can be assigned to the help of laboratory methods of preliminaries. Herpetic lesions of the VII cranial nerve are not often manifested not only by peripheral prosoparesis, but also, in case of a large number of universities, - hyperacusis and hypogesis (Hunt's syndrome). Strike the VIII cranial nerve and start the debut with a noise in the vuhah. Hypoacuse may not be limited only with a lesion of the auditory nerve, but also with a mediocre hearing of the device. Vestibular rosters are prone to develop more and more and vary from mild to severe vestibular ataxies.
With the localization of visins in the area of ​​innervations of the IX cranial nerve, there is a greater deterioration in sensitivity in the area of ​​weak weakness, weakness of the arch, tongue, back stage of the pharynx.
In addition to the development of herpetic radiculomas and neuritis, sometimes it is more difficult to prevent breakdowns, so that you can develop the zones of sensory breakdowns.
Defeat the shinnyh universities with supervised hanging on the shinnyh and the hairy part of the head. With ganglionitis of the lower and upper chest localization, Steinbrocker's syndrome can be promoted Ganglionitis of the chest localization does not simulate the clinical picture of angina pectoris, myocardial infarction, which can be brought to the point of diagnostics. In case of herpetic lesions of the ganglions of the transverse-kryzhovoy dilyanka, vinik is bil, which simulates pancreatitis, cholecystitis, nirkov colka, appendicitis. Symptoms of Neri, Lasseg, Matskevich, Wasserman are associated with the development of ganglioradiculitis.
Neurogenic dissection mycouris due to deformities of secularization for the peripheral type can be associated with operative herpes of sacral dermatomes S2-S4. Gostriy that chronic herpetic encephalitis and mієlіt є with serious acceleration, so that it is not easy to produce until death or invalidization.
Pain syndrome is the most painful manifestation of lichen operculus in case of severe peripheral nervous system. In some patients, it may seem to be an altogether short triviality, in 10-20% of ailments there is postherpetic neuralgia in 10-20% of ailments, as there can be a few moments of rock. Significantly diminishing the quality of life, it can be produced up to three-hour timelessness and supervised with sutta financial vitrates. An axis of more effective treatment of pain syndrome associated with operative herpes, є important clinics.
Surely with the occasional symptoms, the pain syndrome in case of operative herpes has three phases: gostru, pidgostru and chronic.
Gostra herpetic neuralgia vinikє, as a rule, in prodromal period and triv up to 30 days. In most patients, there is a pain and visipa before the appearance of the liver, or itching in the singing dermatomy. Bіl can be prickly, pulsating, shooting, be attacking or persistent in nature. In a number of ailments, the pain syndrome is supressed by systemic fiery manifestations: fever, nezduzhannyam, mіalgіyami, headache. Visually identify the cause of the pain at the stage of the second stage. Already from the localization of the differential diagnosis of stenocardia, myocardial infarction, cholecystitis, pancreatitis, appendicitis, pleurisy, intestinal colitis, vertebral radiculopathy. The cause of the pain syndrome begins to grow evidently when characteristic symptoms appear. A non-mediated cause of prodromal pain is subclinical reactivation and replication of VZV in nerve tissue. The presence of severe pain in the prodromal period of an increased degree of severe herpetic neuralgia in the period of visceral and imaging development of a herpetic neuralgia.
The large (60-90%) immunocompetent patients will have a strong visipan supervodzhuzhu strong gostry bil. The incidence of painful pain syndrome increases from the very beginning. A characteristic feature of the state of herpetic neuralgia is allodynia - bile, viklikaniy in the inflow of non-painful stimulus, for example, doty ogyagu. Vvazayut, scho alodynia in the state of the phase є a predictor of the diagnosis of postherpetic neuralgia.
During the phase of herpetic neuralgia, it is repaired after the end of the phase (after 30 days from the ear of the prodromal period). On the basis of an adequate treatment, it can be bought or it can take more than 120 days, turning into postherpetic neuralgia. To the factors that will save you pain, consider: lіtnіy vіk, to become, the manifestation of a trivial prodromal period, a massive visibility, localization of the visibility in the area of ​​the innervation of the triple nerve (especially the area of ​​the eye) or brachial plexus, strong hospitality and immunity
For postherpetic neuralgia patients, describe three types of pain:
1) long-term, gliboky, dull, to crush or to crush a baking ball;
2) spontaneous, periodical, prickly, flickering beat, similar to a blow with a strum;
3) bіl at odyagannі or mild dots (in 90% of the ailments).
It is well known from the International Forum for the treatment of herpes, postherpetic neuralgia, which starts as early as 4 months. (120 days) on the cob of prodromal period of the operative lichen.
Pain syndrome, as a rule, leads to impaired sleep, second appetite and decreased vagi, chronic vomiting, depression, leading to social maladjustment of patients.
If in the hostile phase, the pain syndrome is of a decrease (fiery and neuropathic) character, then in the chronic phase it is a typical neuropathic disorder. The skin in the perekhovannyh phases of its own peculiarities of treatment, based on the pathogenetic mechanisms of pain syndrome and susceptibility to control by clinical illnesses.
I am depriving of operative deprivation in Danish hour є as an actual interdisciplinary problem, it’s not only dermatovenerologists and neurologists who take part in the virus, but also of infectious diseases, ophthalmologists, otorhinolaryngologists.
Vibor etiotropic therapy drugs in case of operative herpes infection infect synthetic acyclic nucleosides (acyclovir and analogs - famciclovir and valciclovir). Naybilsh kindly vivchenim u tsei hour є acyclovir. Mechanism for the development of acyclovir on the interaction of synthetic nucleosides with replication enzymes of herpesviruses. Timidinkinase of herpesviruses in nabagato shvidshe, nіzh kіtinna, call for acyclovir, in which case the drug is accumulated importantly in the clinics. Acycloviri vishykuyutsya in the lance of DNA, which awakens, for "daughter" airborne particles, shaving off the pathological process and causing the reproduction of the virus. Valacyclovir develops a high bioavailability, so it is possible to speed up the dose and the multiplicity of the drug taken. Famcyclovir, for the development of food spores to new timidinasis of herpesviruses, lower to acyclovir, I am more effective in treating operative lichen.
The main schemes of antiviral therapy for operative herpes in older patients are used: valacyclovir 1000 mg 3 times as needed. orally for 7 days, or famciclovir 500 mg 3 times for dobu. orally for 7 days, or 800 mg acyclovir 5 times for dobu. orally for 7-10 days. A slid of memory, which acyclic nucleosides, and later signs of yakomog earlier - in the first 72 years at the moment of appearing visipan on shkіrі.
Yak is meant to be a viscera, pathogeneticly affecting the development of the phase and becoming ill with its own particularity. At the prodromal and state level, the prescription of anti-inflammatory drugs (NPZP), anti-inflammatory, desensitizing therapy is indicated.
Yak vidomo, the "gold standard" of efficiency of NPZP, the standard of therapeutic potential and safety of new and "old" drugs in the whole group - diclofenac sodium. Testing of diclofenac was carried out in all spheres of clinical monitoring of the refinery, its effectiveness was brought in during the course of randomized clinical diagnostics for urgent cases, as well as for chronic pain. At the same time, in the course of numerical dosages, it is shown that it is not possible to change diclofenac for efficiency from the non-steroidal anti-fiery ones, while at that time it is possible for them to act on the basis of safety. On the thought of a number of authors, the Russian Federation has diclofenac in the most popular oil refineries, which has been zoomed in front of the financial availability of the generic drug. For dany opituvannya 3 yew. There are ailments in Moscow and the other 6 regions of Russia, where oil refineries are regularly consumed, and 72% of the respondents took the drug vicorisation. However, the cheapest generics were not given to the great clerical presenters for their efficiency and safety, which cannot be said about original drug diclofenac and its analogs.
The positive qualities of diclofenac are overtaken by the optimal physical, chemical and structural characteristics of the drug, which can be penetrated and accumulated in the flames, as well as by the garnishing sum of the baggage with the sunken people. Protisapalny for diclofenac is pummeled due to the activity of cyclooxygenase 1 and 2 (COX-1 and COX-2). COX-1 is involved in the structural, and COX-2 - in the inductive form of the key enzyme in the metabolism of arachidonic acid. COX-1 will prevent the synthesis of prostaglandins (PG), which will take part in the secretion of the slurry mucus, it will have bronchodilator power. Prostacyclin is capable of expanding and disaggregating power, reducing microcirculation in nirkas, legends and pepsi. COX-2 will preserve the synthesis of GHGs, so take the fate of ignition process, and appear deprived of the heat. The prototypal activity of the non-steroidal prototypes of the prototype is pummeled by the COG-2 itself. The majority of non-selective non-steroidal anti-fiery prototypes, including іngіbuє TsOG-1, nіzh TsOG-2. Diclofenac ingibu offending the isoferment is approximately the same world, which is before the disease of the intestinal tract (gastrointestinal tract). The drug disrupts the metabolism of arachidonic acid and reduces the amount of PG in the midst of firing, as well as in healthy tissues, induces an exudative and proliferative phase and fumes. The greatest efficiency of this activity is indicated in case of pains of a fiery nature, but it is important for the treatment of severe herpetic neuralgia.
Yak and all non-steroidal anti-inflammatory agents, diclofenac has antiplatelet activity. However, wine does not compete with acetylsalicylic acid for a link with the active center of COX-1 and does not infuse an antiplatelet effect on it.
Diclofenac reduces the penetration of capillaries, stabilizes the lysosomal membrane, reduces the absorption of ATP in the processes of oxide phosphorylation, reduces the synthesis of mediators igniting (PG, histamorin, bradycinin, component, factor). The drug blocks the interaction of bradikinin with tissue receptors, in addition to the deterioration of microcirculation and decreases the painful sensitivity of the brain. The analgesic action is accompanied by a decrease in the concentration of biogenic amines, as well as algo-genic powers, and an increase in the threshold of pain sensitivity of the receptor apparatus. With trivial stasis, you can fix the desensitizing effect.
As for the rhizic of the serous festering, then the diclofenac is not baked, but the SHKT is not baked, the lower the nonselective non-steroidal anti-fiery defenses, and the patients with the apparently low rhizic are slower than those who are not selective.
However, the total frequency of acceleration from the side of the shlunkovo-intestinal tract, before dyspepsia on the background of diclofenac, significant viscera, lower with vicorian cericoxib, celecoxib, nimesulid and meloxicam. Stagnation of diclofenac is associated with the promotion of the risk of destabilization arterial hypertension that heart failure, as well as the development of cardiovascular disasters. Diclofenac may suffer serious hepatotoxic delay, if the pathology of the liver is clinically severe.
On the other hand, on the thought of old people, because of the problems of sickness, tolerance and low health of diclofenac, you can use a vibration preparation for treating hospitable and chronic pain in gastrointestinal patients, who don’t think of serous diseases. hepatobiliary. systems. With a thin rhyme - in a person with a kidney disease without a serious comorbid pathology or an ailment in a malignant history (without a serious delay) - diclofena can also have a history of a history of a combination of gastroprotective diseases, ale for a disease
In case of postherpetic neuralgia, as well as chronic neuropathic pain, the first plan is to take medications to treat patients with peripheral and central sensitization and activate the antinociceptive system. Prior to such drugs, antidepressant drugs are used (reversal is given to selective inhibitors of the vortex absorption of serotonin and norepinephrine) and anticonvulsants. Shown for neuroprotective drugs.
I have a complex treatment for a severe, and chronic pain in vikoristovuyut vitamins group U. The metabolic and neurotrophic effect of vitamins B1 (thiamins), the most important component of the physiological system and the conduction of nerve impulses, is described. It has been established that vitamins B6 and B12 (pyridoxine and cyanocobalamin) play an important role in the processes of milling of nerve fibers. Pyridoxine takes care of the fate of the synthesis of mediators in the peripheral and central nervous systems. A number of robots accept, as a combination, so the distribution of vitamins B1, B6, B12 has an analgesic effect. It has been reported that the combination of vitamins In the case of pain in the inflammation of nociceptive nociceptive symptoms, no change in the introduction of naloxone, due to the noradrenaline and serotonin - the head "antinociceptive" neuromedical.
A number of experimental studies have shown a viral antinociceptive effect in patients with neuropathic pain. With the use of a complex of vitamins in groups of 3 types. 1149 patients with pain syndromes and paresthesias, polyneuropathies, neuralgias, radiculopathies, mononeuropathies, a decrease in the intensity of pain and paresthesias in 69% of patients was indicated. In view of the development of anti-nociceptive activity in the complex of vitamins in I. Jurna in 1998, after analyzing the experimental and classy days, the bully at that hour, it’s good for the summer, this summer in the spin.
Due to a synergistic effect in decreased tactile alodyne in case of a one-hour concussion of vitamins B12, B1 and the anticonvulsant carbamazepin or gabapentin, which is important for realizing the mechanisms of delayed medication for one hour
One of the drugs, which is to replace the complex of vitamins of group B, є neuromultivit, can be used in a dose of 1-3 tablets for a duration of 1-2 msec. is a significant part of the effectiveness of therapy. The inclusion of neuromultivation in the complex therapy of pain syndrome allows one to reach a greater degree of development in case of one-hour stagnation with non-steroidal anti-fatigue diseases, to change the triviality of the disease to pain and the triviality of therapy, to speed up the rate of recurrence.
On a particular note of merit, the drug Neurodiclovit is to be given in 1 capsule with modified vivilnennym 50 mg of diclofenac sodium, 50 mg of thiamin hydrochloride, 50 mg of pyridoxine hydrochloride and 250 mcg cyanocaine. The drug is priznachayut at a dose of 1-3 capsules for 1-2 days.
Victory of the combination of vitamins B1, B6, B12 and diclofenac allow to reach a greater amount of analgesic effect, at the same time the triviality of therapy can be changed, so that it will be possible to reach the early stages of the disease. With the combined therapy of gosstroit, the pain for sub-active symptoms of ailments significantly changes earlier than with monotherapy of NPZP. When combining refineries with vitamins of group B, it is possible to reduce the dose of refineries. In some classy preschool children with a complex of vitamins, in the case of ad'juvant therapy, when diclofenac is recognized, a no-nonsense effect is tolerated, but it is not without changes in the scale of the normal intensity of pain for increased
Thus, the most adequate and optimal therapy for herpetic lesions of the peripheral nervous system in addition to antipyretic drugs is a sign of the following complex: NPZP + vitamins B1, B6, B12 (neurodevelopmental) anticonvulsant + vitamins B1, B6, B12 (neuromultivitis), as well as neuroprotective agents.

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