带状疱疹后三叉神经痛临床及病理分析

CLINICAL AND PATHOLOGICAL STUDY ON THE TRIGEMINAL NEURALGIA FOLLOW-ING HERPES ZOSTER

摘要:

目的：探讨带状疱疹后三叉神经痛的临床及病理特点。方法：对34例带状疱疹后三叉神经痛进行临床分析，7例行Dandy氏手术并取病理检查。结果：发病年龄50～60岁20例（59%）。右侧21例（62%）。累及三叉神经I支24例（71%）。并发角膜溃疡12例，角膜炎10例。疱疹后三叉神经痛24例的病理所见，三叉神经感觉根肿胀、轴突变性、节段性脱髓鞘，神经纤维内见淋巴细胞及中性粒细胞浸润。结论：带状疱疹后三叉神经痛是带状疱疹病毒感染所致的三叉神经感觉根急、慢性炎症所致。该病多发生于中老年人，右侧I支较多，易并发角膜溃疡及角膜炎。Dandy氏手术是治疗带状疱疹引起的顽固性三叉神经痛的有效方法。

Abstract:

Objective: To investigate the clinical and pathological feature of trigeminal neuralgia following herpes zoster. Method: Clinical features of 34 case of trigeminal neuialgia after herpes zoster were analysed.Dandy's operation and pathological checks were performed on 7 cases. Rusults: 59% of the patients ranged from 50 to 60. Right side patients were 21 cases (62%), and the first branche of trigeminal nerve was suffered in 24 cases (71%). Eye complications included 12 cases of cornea ulcer and 10 cases of keratitis. Herps were appeared earlier than neuralgia among 24 cases. patholoical changes included the swellings of the trigeminal sensory nerve root, degeneration of axon and demyelinization with infiltration by lymphocytes and neutrophilic granulocytes. Conclusion: The trigminal neuralgia was caused by acute and chronic inflammation of trigeminal nerve fibre infected by zoster herpes virus. It occured usually in middle and old aged persons, while the first branch of right side were common. Cornea ulcer and keratitis were common complications. Dandy's operation was an effective treatment for those chronic intractable trigeminal neuralgia.