Does herpes affect the nervous system. Treatment of neuralgia after herpes zoster

In total, 8 types of herpes infection occur in humans, and the symptoms of different viruses for the most part are not similar to each other. The range of signs of herpes varies from simple - the so-called. "colds" - to psychiatric and oncological diseases.

Symptoms of herpes type 1 - the virus that causes the "cold"

Herpes type 1 is the simplest and most rapidly suppressed virus. The infection is mainly stored in the nerve endings cervical the spine in a dormant state, but with a decrease in immunity or under the influence of stress, it is activated and manifests itself with the following symptoms:

1. At first, the skin turns red and there is a burning sensation and itching.
2. After 6-48 hours, one or more vesicles are formed on the inflamed area - vesicles, inside of which there is a clear liquid.
3. If left untreated or scratched, the vesicles burst, spreading the infected fluid around and causing the damaged area of ​​the skin to enlarge.
4. In place of the burst bubbles, a wound appears, over time, tightened with a crust.
5. Supported by immune system the disease gradually "falls asleep" again - goes into a latent state. Without support - all large areas are damaged, the wounds do not heal normally.

If symptoms are present, a person can infect others through contact. Most often, herpes 1 is localized on the face and mucous membranes of the mouth. It can affect the lips, cheeks, chin, mucous membranes of the nose, eyes, oral cavity or larynx. Sometimes the infection gets on the skin of the trunk, causing the disease to spread to the body.

Symptoms of herpes type 2 - the genital form of the virus

The symptoms of herpes type 2 are similar to type 1, but the localization of the vesicles is different. In a dormant state, this virus is located in the nerve endings of the sacral clutch. Vesicles are formed mainly in the inguinal zone, on the thighs, buttocks, in the anus and genitals.

In addition to the usual symptoms, there is a worsening of mood and mental state, loss of appetite, signs of intoxication. Possible increase lymph nodes in the groin area. In women, vesicles can occur inside the vagina and on the cervix, in men - in the urethra.

Attention! Most often, relapses of the second occur in autumn or winter, when the prevalence of other viral diseases is high. On average, with immune support, symptoms resolve in 2-3 weeks.

Symptoms of herpes type 3 - the Zoster virus that causes chickenpox and shingles

The herpes Zoster virus is usually infected in childhood, and it manifests itself in the form of a common chickenpox. When a child recovers, in the endings of his trigeminal nerve the infection remains forever, however, it does not manifest itself in normal conditions of life.

When immunity falls, a person falls ill with an acute respiratory disease or simply lives unhealthy, the symptoms of the disease appear again. Most often, the lesion occurs in people over 50 years old, while the recurrence of this type of herpes is the rarest (observed in only 5% of patients).

Recurrent disease is called shingles and has the following symptoms:

As a rule, the disease disappears after 1-3 weeks. After the rash appears, the pain is replaced by itching. In rare cases pain do not go away, they subside, but appear throughout life.

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

The Epstein-Barr virus causes a disease called infectious mononucleosis. The disease is quite dangerous and requires treatment to prevent undesirable consequences - deep genital ulcers in women, destruction of blood cells, oncological pathologies (types of lymphomas), autoimmune diseases and syndrome chronic fatigue.

Usually, when infected with the herpes virus type 4, the following symptoms are observed after 7-14 days:

The patient is often thirsty, he has a fever for about a week. Lymph nodes decrease within a month, blood changes can last up to 6 months. Correct treatment leads to recovery and lifelong immunity, its absence leads to chronic form diseases:

1. Erased- muscle pain, aching joints, frequent subfebrile temperature, fatigue.
2. Atypical- frequent relapses of infectious diseases (ARI, diseases of the gastrointestinal tract or genitourinary system).
3. Active- the usual mononucleosis symptoms are complicated by herpetic eruptions, fungal or bacterial infection. Possible damage to the mucous membranes of the gastrointestinal tract, dyspepsia.
4. Generalized- severe damage to the central nervous system, including meningitis, encephalitis, radiculoneuritis. Increased risk of myocarditis, hepatitis, or pneumonitis.

The symptomatology of chronic Epstein-Barr infection manifests itself in waves - the number and intensity of symptoms gradually increase and also gradually decrease depending on the state of the immune system.

Symptoms of herpes type 5 - cytomegalovirus infection (CMV)

Cytomegalovirus does not appear immediately after infection, the carrier of the infection often does not even know about his own situation. With strong immunity, the disease may never go into the active phase, but simply asymptomatically "sleep" in the body until the end of life (in 90% of cases this happens). However, the person will continue to transmit the virus to other people.

Patients with symptoms of CMV most often complain of signs of acute respiratory infections and mononucleosis (fever, fatigue, headaches, chills) that occur 20-60 days after infection. The duration of the disease is generally 4-6 weeks. If the activity of the virus is caused by immunodeficiency, pleurisy, pneumonia, arthritis, encephalitis or myocarditis may join. Vegetative disorders are observed.

In a generalized form, CMV causes damage to the entire body - inflammation of the tissues of internal organs, eyes, brain, as well as paralysis. In men, there may be damage to the tissues of the testicles and urethra, in women - inflammation or erosion on the cervix, uterus, vagina or ovaries, white-blue discharge.

Symptoms of little-studied forms of herpes virus types 6, 7 and 8

Herpes type 6 lives in microphages and lymphocytes. Among all adults, about 50% are carriers of this infection, infecting the rest through blood and saliva, as well as by airborne droplets.

Symptoms of the disease are itchy and mucous, fever, ulcers or spots on the skin of the back, chest or abdomen (exanthema), mononucleosis syndrome, asthenia. With immunodeficiency, encephalitis is possible.

Often the infection occurs in young children (3 months - 4 years). It is manifested by sudden exanthema and fever (up to 40 ° C), signs of intoxication. Symptoms last up to 4 days, then they are replaced by a rash that disappears within 3 days. Sometimes there is no rash after a fever, but there may be convulsions due to too much high temperature. Upon reaching the age of 5, most children develop immunity against type 6 herpes; only a particularly strong immunodeficiency can cause a relapse.

Herpes type 7 contributes to the activation of the type 6 virus and increases the risk of developing chronic fatigue syndrome. This syndrome is the main manifestation viral infection.

It manifests itself with the following symptoms:

• general loss of strength;
• constant fatigue and lack of tone;
• bad mood, anxiety and psycho-emotional overload;
• loss of ability to work and concentration of attention;
• lack of positive changes even after a long rest;
• memory disorders;
• headaches and tearfulness;
• sleep disturbances and lack of sleep even with prolonged sleep;
• signs of depression;
• slight increase in temperature long time(up to six months);
• swollen lymph nodes.

Worth noticing! When making a diagnosis based on these symptoms, a specialist needs to differentiate the disease from psychiatric / nervous pathologies, HIV infection, cancer, anemia, and thyroid dysfunction.

Herpes type 8 least studied. Its symptoms include the development of other diseases - Kaposi's sarcoma, primary lymphomas, Castleman's disease and multiple myeloma. At the same time, the patient has malignant neoplasms on the skin, mucous membranes, internal organs and lymph nodes, looking like symmetrical plaques or dark red or purple spots. There may also be a bloody cough, severe dyspepsia, and pain when eating.

Symptoms of eye herpes of any type

Ophthalmoherpes develops on the retina, eyelids or mucous eyes. Relapses can occur 3-5 times a year - this is one of the most common forms of herpes infection, mainly caused by types 1 and 3 of the virus.

Symptoms eye herpes similar to allergic or from a bacterial infection, herpetic vesicles appear in the eyes, the following signs are also observed:

• eyeballs and eyelids redden;
• there is pain and a feeling as if there is foreign body;
• with good lighting, discomfort is observed;
• visual acuity falls, becomes "foggy";
• sparks or flashes are visible before the eyes;
• the shape and size of objects appear to be irregular or split in two;
• twilight vision is significantly reduced;
• blepharospasms - the eyelids are convulsively compressed.

Patients often complain about severe pain in the eye socket and above the eyebrow. The field of view becomes narrower, there may be a blind spot in the center. Moving the eyes is difficult and painful. All this can be accompanied by nausea, subfebrile temperature and headaches.

Symptoms of herpetic sore throat

In adults and children with the herpes virus in the body, a sore throat caused by this infection is often found. Its onset is usually abrupt and extremely acute:

1. The temperature rises to 40-41 ° C, as in pneumonia.
2. There are severe pains in the throat, it is very difficult to swallow, the discomfort lasts for at least 3 days.
3. The mucosa of the pharynx is subject to swelling, on the tonsils and the palate is visible with white bubbles.
4. Vesicles merge with each other over time, forming a dense white "plaque", covered with a film and surrounded by redness.
5. Suppuration of the rash lasts up to 3 weeks, during which herpes can move to the skin of the face.

The incubation period of herpetic sore throat lasts 1-2 weeks. Sometimes the patient recovers easily - intoxication passes until the rash of vesicles by 6 days, the treatment is greatly simplified. Sometimes there are complications - herpetic rhinitis, chronic tonsillitis, otitis media, myocarditis, encephalitis, etc.

Symptoms of herpes on the internal organs

Internal herpes is manifested by the usual symptoms of other diseases, as it causes them. No visible signs of herpesvirus are usually observed, it is possible to determine the type of infection only by clinical research and laboratory analyses.

As a rule, with ulcers in the esophagus due to herpes rashes, a person suffers from pain behind the sternum and when swallowing. The doctor can detect ulcers through endoscopy. Pneumonia, bronchitis and tracheitis with characteristic symptoms (fever, cough, shortness of breath) are detected through special analyzes for herpes type 1, often these diseases are accompanied by a fungal or bacterial infection.

If the patient has herpetic hepatitis, the symptoms will be similar to those of hepatitis B or C - jaundice, discoloration of urine and stools, fever. To identify the cause of the disease, the patient is prescribed an analysis for herpes viruses. AND so with any other lesion of internal organs - this virus does not have a separate specific symptomatology.

Symptoms of postherpetic neuralgia

Postherpetic neuralgia is an echo of the disease after recovery from type 3 herpes. After a relapse of the Zoster virus, the patient remains a feeling of discomfort and symptoms of infection, although the disease has already “subsided”. Acute symptoms are already completely gone. So, with such neuralgia there are:

• residual drying and flaky crusts in places where it was;
• throbbing pain or tingling in this area, sometimes extremely severe;
• itching between pain attacks, causing irritation, which only increases subsequent pain;
• numbness of the skin areas at the site of the former lichen or an over-strong reaction to external stimuli;
• muscle weakness and paralytic conditions (more often in old age).

Usually postherpetic neuralgia lasts 2-3 weeks, but sometimes it stays for 2 months or even a year. Some symptoms persist even longer, such as muscle weakness or extreme skin reaction. All this interferes with the normal way of life of people who have suffered repeated activity of the varicella-zoster virus.

• stressful situations;

• increase in body temperature.

• swelling of half of the face;

Herpes of the facial nerve, treatment

In medicine, there are many diseases, the provocateur to the formation of which is a viral infection. Most of these ailments affect the human body suddenly, the diseases are equipped with strong and painful symptoms. It has been proven that the human body is a carrier of a number of viruses and pathogenic bacteria, for example, the herpes virus. But all of them are in a passive state until they are provoked to activity by some negative factor.

Under a certain condition, the herpes virus is activated and causes a number of pathological conditions in the patient's body. Herpes of the facial nerve just refers to such pathological diseases that require timely and necessarily high-quality treatment prescribed by qualified specialists.

Treatment

Doctors warn that it is strictly forbidden to self-medicate the inflammatory process in the body. Wrong methods of treatment can cause chronic course illness.

In medical practice against herpes of the facial nerve, the following therapy is used:

• antiviral drugs - Acyclovir;
• immunostimulants - injections with vitamins;
• non-steroidal anti-inflammatory drugs;
• analgesics;
• external ointments of anti-inflammatory action (on the lesions on the skin);
• applications with painkillers (on painful areas on the face).

All photos are taken from a free source Yandex Pictures

Herpes of the facial nerve treatment

Inflammation (neuritis) of the facial nerve

Development mechanism

The facial nerve is a symmetrical nerve that is responsible for the motor and sensory innervation of the corresponding half of the face. It consists of 3 branches, the fibers of which innervate the region of the eyes, cheeks and lower parts of the face. Inflammation of the facial nerve (neuralgia or neuritis) develops under the influence of various damaging factors. At the same time, cells of the immune system surround the site of inflammation and synthesize specific inflammatory mediators - prostaglandins. These biologically active compounds cause irritation of the sensory and motor fibers of the nerve, their swelling and hyperemia (increased blood flow). Due to such effects of the inflammatory reaction, the main symptoms of neuralgia develop - intense pain in the tissues of the face and its asymmetry, as a result of a violation of motor innervation (muscle paresis).

Causes

1. Viral infection is the most common causative factor for inflammation of the trigeminal nerve, which is caused by herpes zoster viruses (herpes virus infection - Herpeszoster). Up to 90% of people are infected with this virus, however, its activation and development of neuritis provokes a decrease in the activity of the immune system after local hypothermia, stress, due to chronic overwork.
2. Aseptic (non-infectious) inflammation as a result of local hypothermia of half of the face - being in a draft, sleeping on the ground. common cause local hypothermia is the presence of a person at an open window in a car while it is moving.
3. Severe physical fatigue.
4. Transferred stress and emotional and mental shock - can provoke an inflammatory process.
5. Hypovitaminosis is an insufficient intake of B vitamins into the body, in which the metabolism (metabolism) in the cells of the nervous system (neurocytes) and their fibers is disturbed.
6. Poor nutrition of a person with frequent malnutrition, leading to general metabolic disorders and depletion of the immune system (secondary immunodeficiency).
7. Chronic infectious pathology of any localization, which leads to the depletion of the protective and adaptive forces of the body.
8. Tumors of tissues and injuries of the base of the skull near the fibers of the trigeminal nerve.

Of all the etiological factors in the development of neuralgia, the most common is the activation of herpes virus infection and the development of herpes zoster with inflammation.

Symptoms of nerve inflammation

Neuralgia of the facial nerve is characterized by the appearance of specific symptoms. They develop only on one side of the face, since the process of inflammation of the nerve is always one-sided. These manifestations include:

1. Severe excruciating pain on one side of the face in the form of a periodic backache. Pain can be localized in the upper, middle or lower third of the face, depending on the predominant lesion of the corresponding branches of the facial nerve. In case of total inflammation of all branches, the lumbago covers the entire side of the face. An attack of pain (lumbago) is provoked by touching the skin of the face, stress factors (hit, visiting the dentist), shaving in men, emotional overstrain.
2. Skewness (asymmetry) of one side of the face due to paresis of facial muscles - characterized by narrowing of the palpebral fissure, drooping of the corner of the mouth on the side of the inflammatory process.
3. Periodic twitching (fasciculations) of facial muscles on the side of the affected facial nerve.
4. Insomnia, increased irritability against the background of pain experienced.
5. Small manifestations general intoxication- pain in all muscles of the body, a slight rise in temperature to subfebrile figures (37.5-37.8º C), weakness and increased fatigue.

In the case of the development of a herpes virus infection (shingles), small blisters filled with a clear liquid (vesicles) may appear on the skin of the affected half of the face.

Diagnostics

The characteristic clinical picture makes it possible to establish the diagnosis of neuritis. To clarify the reasons for its development, an additional instrumental and laboratory diagnostics- X-ray or tomography of the base of the skull, determination of antibodies to the herpes zoster virus.

Treatment of inflammation of the facial nerve

Therapeutic measures for this pathology are aimed at eliminating its cause. In the case of a herpes virus infection, antiviral drugs are used that reduce the activity of the virus - Gerpevir, Acyclovir. The main one is pathogenetic treatment, which is aimed at reducing the severity of inflammation and restoring damaged nerve cells and fibers with the help of medicines several pharmacological groups:

1. Anti-inflammatory (non-steroidal) drugs - block the enzymes responsible for the synthesis of prostaglandin inflammatory mediators, thereby reducing the intensity of inflammation and pain (Nimesil, Diclofenac, Ketanov). In the first days of neuritis, these drugs are administered intramuscularly or intravenously, then, as inflammation decreases, they switch to oral administration of tablet forms.
2. Hormonal anti-inflammatory drugs - have a more pronounced effect compared to nonsteroidal drugs, are used in a hospital setting (Hydrocortisone, Dexamethasone).
3. B vitamins that restore metabolism in nerve cells and fibers.

Treatment of neuritis at home can be carried out using tablet forms of drugs, provided that it is not severe.

Neuritis of the facial nerve

Diseases of the peripheral nervous system are very diverse, they have different localization, etiology, their symptoms also differ. Only one thing definitely unites all these pathologies - they are all extremely painful and unpleasant. But even against this background, neurosis of the facial nerve stands out, which not only causes severe pain and disrupts functions, but also brings psychological discomfort and suffering to a person.

It is more correct to call this disease neuritis (or neuropathy) of the facial nerve, because this ailment is a consequence of damage to the facial nerve. This can lead to partial paralysis of facial muscles, facial symmetry, and other symptoms that we will discuss below. The disease can change a person's face beyond recognition, make it repulsive.

Before describing the symptoms and starting treatment, one should understand the nature of this disease, the mechanisms of its development and the causes that cause this pathology.

General information

What is facial neurosis, why does this pathology develop? Neurosis (or neuritis) of the facial nerve is an inflammatory disease that affects one or two branches of the facial nerve, which leads to the onset of paralysis or paresis of the facial muscles.

The facial nerve is one of the twelve cranial nerves and passes through the ear opening and exits through the opening in the temporal bone. This is a motor nerve, its main task is to innervate the facial muscles.

There are two types of neurosis of the facial nerve: primary, which most often begins after hypothermia, and also secondary, it is the result of various diseases.

Symptoms and treatment of neurosis of the facial nerve are related to which part of it is affected. The causes of these symptoms are very numerous:

• hypothermia (cold neuritis);
• herpes;
• parotitis;
• mechanical compression (tunnel syndrome);
• malignant and benign neoplasms;
• circulatory disorders.

Otitis and neglected diseased teeth can also lead to the onset of this disease. These are not all the reasons that can cause neurosis of the facial nerve.

Symptoms of the disease

Symptoms, as well as treatment of the disease, depend on the location of the lesion. If the lesion occurs at the level of the nerve nucleus, weakness of the facial muscles is observed, if the damage is localized in the brain stem, strabismus is observed - a symptom associated with damage to the abducens nerve, which innervates the external muscle of the eye, which pulls out its paresis.

If the facial nerve is affected at the outlet of the brain stem, then hearing impairment is observed, because in this case the auditory nerve is also damaged. In case of nerve damage in the temporal bone canal, salivation disorders, dry eyes, taste disorders are observed - these symptoms are associated with damage to the intermediate nerve.

There is a so-called Hunt syndrome - this is a lesion of the ganglion, through which the innervation of the middle ear, palate, auricle. This process usually affects the facial nerve passing here. This disease is characterized not only by paresis of the facial muscles, but also by hearing impairment, as well as severe pain in the ear area, radiating to the back of the head and to the temporal region. In this case, structural damage inner ear can lead to impaired coordination of movements, dizziness.

Very often, this disease begins imperceptibly, proceeds gradually and its treatment begins when problems arise with the facial muscles. The patient's nasolabial fold is smoothed out, and the face warps in a healthy direction.

Weakness of facial muscles leads to the fact that the patient cannot close his eyelids, cannot smile, bare his teeth, stretch his lips, or make other movements of the facial muscles. Since facial expressions play a very important role in everyday communication, the patient has social and psychological problems. It is possible to turn the eye up when trying to close it (Bell's syndrome) or "hare's eye".

If other cranial nerves are affected, additional symptoms are observed: dry eyes or excessive salivation, increased auditory sensitivity.

Another cause of neuritis of the facial nerve can be otitis media. In this case, the infection spreads to the facial nerve. There are sharp pains in the ear, which are accompanied by typical symptoms of neurosis of the facial nerve.

Another cause is the Melkerson-Rosenthal syndrome, an inherited condition that causes swelling of the face and wrinkling of the tongue.

Treatment

Treatment of neurosis of the facial nerve depends on the cause of the disease. It is necessary to find out the location of the nerve lesion and the cause that caused it. To make a correct diagnosis, the doctor should pay special attention to additional symptoms that accompany the weakening and paresis of the facial muscles characteristic of facial nerve neuropathy.

The clinical picture of this disease is very clear and bright and usually, therefore, its diagnosis usually does not cause any special problems for physicians. For additional information, CT and MRI of the brain are sometimes used (for secondary lesions).

To determine the exact location of the lesion, electroneurography, nerve evoked potentials, and electromyography are used - these methods allow you to accurately determine the location pathological process which is very important for treatment.

Treatment of this pathology depends on its nature and cause of development. If we are talking about primary neuritis, then glucocorticoids (prednisolone), vasodilators, decongestants, vitamin complexes (group B vitamins) are used to treat it.

If the disease is secondary, then the main forces should be directed to eliminating the underlying cause.

For the treatment of neurosis of the facial nerve, the use of non-drug methods is very effective: physiotherapy (it begins to be used almost immediately), massage and physiotherapy exercises, ultrasound and electrical nerve stimulation.

Complications

If the patient does not receive adequate treatment, this can lead to the development of complications.

The most common complication is contracture of facial muscles. In this case, the affected muscles tighten, causing severe discomfort to the patient.

Neuritis of the facial nerve is an inflammatory or ischemic lesion of the facial nerve, manifested by unilateral paralysis or paresis of the mimic muscles of the face.

With the diagnosis of neuritis of the facial nerve, treatment is carried out individually, depending on the cause of the symptoms - an infectious lesion (herpes virus), ischemic or otherwise, as well as the presence or absence of an inflammatory process.

Treatment of neuritis of the facial nerve in integral medicine is based on the use of reflexology methods (acupressure, acupuncture) and physiotherapy methods.

Neuritis of the facial nerve symptoms

Facial expressions are provided precisely by the facial nerve, therefore, its defeat - neuritis of the facial nerve - is manifested primarily by paralysis or paresis of the facial muscles. The affected part of the face freezes, turning into a mask, the face becomes distorted, becomes asymmetrical, the corner of the mouth drops, the eyelid stops closing, and eyeball protrudes and turns upward. These are the main and most characteristic symptoms neuritis of the facial nerve.

In addition, with the diagnosis of neuritis of the facial nerve, the symptoms are manifested by a violation of sensitivity - numbness of a part of the face, a violation of taste (loss of taste sensations).

Other symptoms of facial neuritis - heightened sensitivity to loud sounds (hyperacusia), tinnitus, ear pain - are associated with the passage of the facial nerve through the internal auditory meatus and the parotid gland near the auditory nerve.

When diagnosed with neuritis of the facial nerve, the symptoms also affect the secretory activity of the glands, which is manifested by excessive or insufficient salivation (dry mouth), watery eyes or dry eyes.

Neuritis of the facial nerve causes

The facial nerve is one of twelve paired cranial nerves that provides motor activity and sensitivity to the face (facial muscles). The facial nerve has two branches. As a rule, neuritis affects one of the branches of the facial nerve, which causes unilateral symptoms.

Neuritis of the facial nerve can occur as a result of infection with the herpes virus, but in most cases, neuritis of the facial nerve is non-infectious in nature.

Depending on whether infection occurs or not, there are primary neuritis of the facial nerve (non-infectious) and secondary, or symptomatic, neuritis of the facial nerve (infectious).

The most common form of primary neuritis of the facial nerve is catarrhal neuritis resulting from local hypothermia of the face (exposure to cold, wind, draft). Another common cause of primary facial neuritis is insufficient blood supply (ischemia) to the nerve due to vascular problems.

Secondary neuritis of the facial nerve, in addition to infection, can be caused by trauma or an inflammatory disease of the ear - otitis media, eustachitis. mastoiditis (the so-called otogenic neuritis).

It should be noted that neuritis of the facial nerve can occur without the inflammatory process. In such cases, experts talk about neuropathy of the facial nerve.

Factors contributing to the occurrence of neuritis of the facial nerve may be metabolic disorders in the body, endocrine disorders ( diabetes), hypertonic disease. atherosclerosis. intoxication of the body (poisoning with toxic substances), errors in dental treatment (injury, infection). But the most common factor in the occurrence of neuritis of the facial nerve is a disorder of the nervous system - emotional lability, the consequences of nervous stress, inadequate response to stress (low stress resistance). The combination of the nerve factor with local hypothermia is the most common cause of facial neuritis.

Neuritis of the facial nerve treatment

When neuritis of the facial nerve is diagnosed, treatment should begin as early as possible - preferably already in the first hours after the onset of symptoms. In this case, the success of the treatment of neuritis of the facial nerve will be maximum and in 75-80% of cases it will completely eliminate the symptoms of the disease.

Treatment of symptomatic neuritis of the facial nerve (secondary) should be aimed primarily at eliminating the ear disease that caused the symptoms - otitis media, eustachitis. To do this, integral medicine uses complex anti-inflammatory therapy with the help of medical procedures (reflexology, physiotherapy).

Treatment of neuritis of the facial nerve of the primary type includes methods of acupressure with massage and acupuncture. In some cases, pharmacopuncture is used.

An important component of the treatment and prevention of recurrence of neuritis of the facial nerve is to restore the balance of the nervous system, increase stress resistance with the help of medical procedures, as well as immunomodulatory therapy to increase general and local immunity. In the event that ischemia has become the cause of neuritis of the facial nerve, treatment is prescribed to improve the blood supply and nutrition of the nerve tissues and eliminate vascular problems.

Such a complex individual treatment of facial neuritis shows a very high efficiency and in most cases allows you to restore the motor activity of the facial muscles, eliminate paresis and facial distortion, taste and hearing disorders, restore facial sensitivity and secretory activity of the lacrimal and salivary glands.

To book an appointment with a specialist

Herpes - varieties and treatment of herpes

For some reason, many people think that all microorganisms, and even more so viruses, are always and under any conditions our irreconcilable enemies. But this confrontation between the macroorganism and the microorganism does not always occur. And, often, the purpose of the doctor's work is to prevent the occurrence of conflict.

Meet Herpesviruses

There is an ancient group of large viruses, which contains more than 100 species and several families. These are herpes viruses. At healthy person many of them circulate asymptomatically in the cells of the central nervous system, in a "sleepy" state, and do not cause any harm. To show the ratio of the size of the body of a neuron and the size of the herpes virus, we present a simple calculation. The body size of an average neuron is µm, or 0.06-0.08 mm. The size of the "body" of one herpes virus is 150 nm. This means that only viruses stacked in one row will occupy the size of the cell body. The ratio is about the same as that of a human in relation to the size of a large cruise ship.

This is what herpes viruses look like

Therefore, several tens or hundreds of virions "doze" in the cells of every healthy person. Therefore, questions like “how to cure herpes forever”, or “how to cure genital herpes” are meaningless. Under the "cure" of herpes, even according to the most severe and aggressive scheme, it means:

• cessation of replication, that is, the reproduction of the virus;

• making it inactive.

Thus, it is only required to "drive the beast into a cage." Why is radical treatment of herpes impossible? Because these viruses have a very high affinity (tropism, affinity) for the nervous tissue. They, once in the human body, settling on the mucous membrane respiratory tract, penetrate into the nerve endings, and with the current of the neuroplasm penetrate into the central nervous system. And there are a lot of these viruses in the surrounding air.

In the event that a person's immunity decreases, then there is an "awakening" and replication (multiplication) of the virus, which is accompanied by a pronounced cytopathic effect on cells. The classic sign of any herpetic lesion is a spot that turns into a bump, then into a bubble with a clear liquid. It bursts, erosion occurs, and then, when dried, a crust.

In the event that erosion occurs on the mucous membranes, severe pain appears. Sometimes the virus "loves" to pour out along the nerve trunks, as butterflies love to pour out next to the spruce forest. In this case, a “path” of bubbles is noticeable, repeating the path of the nerve. Often, the intercostal nerves are affected, but sometimes the trigeminal and facial nerve trunks are affected.

Herpes infection in the human body can affect many organs and tissues, for example, in addition to the usual "herpes simplex", or herpes simplex, there is also genital herpes caused by a second type virus. In addition, it is possible to develop:

• acute herpetic respiratory inflammation, herpetic SARS;

• eye damage, or the development of ophthalmic herpes, which must be treated in a hospital, since the outcome may be complete blindness;

• Meningitis or encephalitis. The defeat of herpes brain still leads to a large percentage of deaths;

• lesions of parenchymal organs. Weakened immunocompromised patients develop herpetic hepatitis or pneumonia. These diseases are severe. A secondary bacterial infection is often associated, resulting in septic conditions;

• congenital malformations associated with generalized herpes infection in newborns.

How to cure herpes at home? Treatment of herpes in adults in any case involves the use of antiviral drugs, as well as immunomodulators. We will analyze how herpes is manifested and treated in the most common cases.

Herpes simplex

Principles of therapy for herpes infection

It should be said right away that herpes in any manifestation, regardless of localization, should immediately begin with the appointment of antiviral drugs. You can treat herpes as much as you like with folk remedies, but if you do not use antiviral drugs, then this process will be long.

Therefore, it is necessary to start with them. The classic drug is acyclovir. They are treated for genital herpes, rashes on the nasal mucosa, on the lips, as well as the treatment of herpes zoster.

Of course, acyclovir can also be of varying degrees of purity, so it is better to purchase effective drugs, for example, Zovirax, which is produced in the European Union.

In the event that herpes just appeared on the lip, then you can simply smear the site of the rash with an antiviral cream several times a day, which contains a 5% concentration of the active drug. How to cure herpes on the lips? In the event that the general state of health does not suffer, or there are signs of ARVI, then in combination with the usual pathogenetic therapy (plentiful drink, vitamins, immunomodulators), the “cold” on the lips quickly disappears.

Immunomodulators include complex herbal preparations, dietary supplements, or vitamin and mineral complexes. Common immune boosters include:

• perga, royal jelly, propolis, honey;

• mumiyo;

• sources of vitamin "C" - currants, cranberries, lingonberries;

• preparations of aloe, lemongrass, ginseng, golden root. They are called "adaptogens", and increase the nonspecific resistance of the body;

• dihydroquercetin, obtained from the Siberian larch (drug "Taxifolin Baikal", the company "Siberian cedar".

Taxifolin - the best remedy to strengthen the immune system, and therefore to fight herpes

Therefore, if you want to know how to quickly cure herpes that occurs in uncomplicated forms, then you need to understand that you cannot do without strengthening immunity.

When are tablets shown?

In addition to local preparations, for example, antiviral creams and ointments, enhanced therapy is sometimes prescribed - antiviral tablets are used. This may be the same acyclovir, valaciclovir ("Valtrex"), or other drugs. Their action is the same, but it is enhanced by an “attack from two fronts”: the cream acts from the side of the mucous membrane, and taking the medicine inside creates the desired, effective concentration in the blood.

This combination therapy is indicated for the treatment of herpes zoster in adults, as well as the treatment of genital herpes.

One tablet of the drug contains 200 mg of the substance, and you need to take it five times a day. In the event that a person is awake for hours, then Zovirax should be taken every three hours. So you need to take drugs for a week, or 10 days.

Treatment of herpes in intimate places should also be combined: local therapy with a cream or ointment in the area of ​​​​rashes, and taking antiviral drugs inside.

Herpes in intimate places

Treatment of genital herpes should be carried out, making sure that therapy should not be supplemented with antifungal treatment. In the event that at first there is a urogenital infection, for example, chlamydia, then you first need to cure it, and then proceed to the elimination of herpetic manifestations and the fight against fungi, for example, vaginal candidiasis.

Also, combined antiviral treatment is indicated, for example, for Bell's palsy, or paresis of the facial nerve. In the case when half of the face “hangs”, herpes is often to blame, which occurs in the external auditory canal and leads to swelling of the facial nerve in a narrow bone canal.

With paresis of the facial nerve, treatment with acyclovir should be started urgently, even before any visits to the doctor. The later the therapy is started, the less likely it is to restore the mimic muscles of the face.

We strengthen immunity

How to cure herpes in these more common forms? In this case, it is necessary to use immunomodulators, which are called interferon synthesis inducers. These include "Viferon", which can be used in rectal suppositories, "Ridostin", or sodium nucleinate, as well as interferon preparations for parenteral administration ("Roferon-A", "Reaferon", gamma - interferon) and other means. Of course, do not forget about simple ways to raise immunity.

Everyone knows the Viferon candles, which are becoming more and more expensive every year.

About intravenous administration of antiviral drugs

With a herpes infection, the occurrence of such severe cases is possible that only the introduction of antiviral drugs according to an enhanced regimen intravenously can suppress the replication of the virus. These options include:

• penetrating ophthalmoherpes, which can lead to complete blindness;

• herpetic meningitis and encephalitis (sometimes the introduction of antiviral drugs endolumbally is indicated so that they penetrate into the cerebrospinal fluid);

• congenital and acquired forms of herpetic infection in newborns;

• a combination of herpetic generalized infection on the background of HIV in the AIDS stage.

In some cases, intravenous antiviral drugs are also indicated if it is necessary to ensure that a recurrence of herpes does not occur. For example, in the event that a woman with genital herpes during pregnancy experienced an episode of exacerbation, and it was cured, then shortly before childbirth, intravenous administration acyclovir. In this case possible harm from the fact that the baby catches a herpes infection in a generalized form, obviously exceeds the harm that the drug can cause.

Intravenous administration is required, for example, when herpes appears on the background of taking immunosuppressants after a kidney transplant and in other, special cases.

With the treatment of herpes, everything is more or less clear. What about the treatment of postherpetic neuralgia? Are antivirals or immunomodulating therapy indicated here?

About postherpetic neuralgia

Treatment of neuralgia after herpes zoster is a difficult and sometimes impossible task. For years, patients experience excruciating, burning pains at night, at a time when herpes in the intercostal space has long been gone. This is because the virus was able to cause a "rebirth" of the nervous tissue, and the nerve begins to spontaneously generate false signals. pain impulses, and without any reason.

Treatment of postherpetic neuralgia sometimes involves (of course, in the West), the use of narcotic analgesics. Let's leave the unavailability of the patch with fentanyl in Russia, even for cancer patients, on the conscience of the state, and let's just say that when shingles appears, you can not hesitate.

In the same way as with Bell's palsy, any delay in the appointment of etiotropic treatment increases the risk of developing postherpetic neuralgia.

If this happens, you will have to take long-term special anticonvulsant drugs for neuropathic pain (this is what this post-herpetic pain is called), look for capsaicin remedies, take antidepressants and suffer from chronic, excruciating and burning back pain for many years.

Therefore, in the event that you see a bubble rash in the intercostal space, then urgently make an appointment with a doctor - a neurologist, but while you are waiting for an appointment (after all, it may take several days) - urgently start taking acyclovir inside, start lubricating the rashes with an antiviral ointment or cream, and boost your immunity. In this case, you have every chance that the virus will leave the nerves without causing them any harm.

Herpes of the facial nerve symptoms

Neuritis

Neuritis

Neuritis is called inflammatory disease peripheral nerve (intercostal, occipital, facial or limb nerves), manifested by pain along the nerve, impaired sensitivity and muscle weakness in the area innervated by it. Damage to several nerves is called polyneuritis.

The clinical picture of neuritis is determined by the functions of the nerve, the degree of its damage and the area of ​​​​innervation. Most peripheral nerves consist of different types of nerve fibers: sensory, motor, and autonomic. The defeat of the fibers of each type gives the following symptoms, characteristic of any neuritis:

Tests confirming ulnar neuritis:

Symptoms and clinical picture with the localization of herpes on the face

Ordinary herpes on the face looks like compact groups of small vesicles - papules. On closer examination, it can be seen that such bubbles have a transparent shell and are filled with the same transparent liquid.

Herpes zoster usually causes very extensive skin lesions on the face. Most feature his - rashes only on one side of the face.

Herpes zoster on the face of a child develops extremely rarely. The so-called shingles is a disease of adults, and in children the virus almost never causes relapses.

The regimen of taking the tablets is prescribed by the doctor.

The use of funds based on Interferon (Reaferon, Genferon, Viferon) makes sense only with a complicated course of the disease and only if the doctor insists on it. In some cases, the use of these drugs can speed up recovery, but sometimes they also lead to serious side effects.

The herpes vaccines currently in development or in experimental use do not provide reliable protection against the virus. In addition, they are intended for those who have never had herpes before - as a protection against infection. If a person has already had herpes, then vaccination will be useless for him.

To protect against infection with herpes, it is necessary to limit contact with people with clear signs of primary or recurrent infection in active phase. The most dangerous person with fresh rashes and herpes at the stage of proliferation (rupture) of papules.

Prevention of herpes in children is that sick parents or relatives do not communicate with the child until complete recovery. If contact is necessary, the patient should wear a tight cotton-gauze bandage. This rule is also true for breastfeeding mothers.

Useful video about herpes and its potential danger to humans

Neuropathy (neuritis) of the facial nerve

Neuropathy is called damage to the nerve with a violation of its functions. Neuritis of the facial nerve is a special case of neuropathy, which means inflammation of the nerve fiber.

Currently, the term "neuritis" is not used. The diagnosis is formulated as neuropathy of the corresponding nerve, indicating the cause that caused the pathological change in functions.

The facial nerve is mixed, it consists of motor fibers that innervate the facial muscles of the same half of the face. From him ( VII couple CHMN, n. faciales) branches depart to eardrum, parasympathetic fibers to the sublingual and mandibular salivary glands, to the lacrimal gland, as well as sensory fibers that provide taste sensations from the anterior 2/3 of the tongue.

Causes of neuropathy of the facial nerve

Neuropathy nervus facialis can be caused by various causes: toxic, infectious, compression-ischemic, allergic, inflammatory. Quite often, neuropathy VII craniocerebral insufficiency occurs when it is compressed in a narrow canal during inflammatory processes and infectious processes: otitis media. herpes, mumps. poliomyelitis. The cause may be poisoning, compression by a tumor (acoustic nerve neuroma in the pontocerebellar angle) or vertebral artery aneurysm, trauma, allergic reactions. Often the disease is preceded by hypothermia.

Symptoms of damage to the facial nerve

Depending on the level of damage to the facial nerve, there are various pathological symptoms. Involvement in the pathological process of the facial nerve or its nucleus leads to movement disorders peripheral type. There is a paresis of facial muscles on the side of the lesion, capturing the entire half of the face, with the exception of the muscle that lifts upper eyelid(innervated by the oculomotor nerve). This peripheral paresis differs from the central paresis, in which the violation of facial expressions occurs below the corner of the eye.

On the side of the focus, facial expressions are depleted, a condition called Bell's paralysis (or prosoparesis) develops: the drooping of the corner of the mouth and the smoothness of the nasolabial fold, the absence of wrinkles on the forehead, the impossibility of tightly closing the eyes. Whistling is impossible, the patient cannot blow out the candle, there are difficulties in eating, sometimes there is a violation of salivation. When you try to close your eyes, the eyeball goes up, and a white strip of sclera is visible in the space between the eyelids (Bell's symptom). Violation of the innervation of the lower eyelid leads to the fact that the tear does not enter the lacrimal canal, but flows out.

Damage at the level of the cerebellar-pontine angle leads to the reverse state: xerophthalmia occurs - dry eyes, an infection easily joins with the development of conjunctivitis, episcleritis, which are accompanied by impaired taste and deafness. With a lesion in the area of ​​\u200b\u200bthe internal auditory canal, the same symptoms are noted, but instead of deafness, hyperacusis is noted: all sounds seem excessively loud, harsh, rattling.

Neuropathy of the facial nerve with herpes is often accompanied by Hunt's neuralgia, which is manifested by severe burning and pain in the ear canal. At the same time, herpetic eruptions are observed in the area of ​​​​the auricle, external auditory canal, tympanic cavity, uvula, palate, tonsils, and sometimes on the face, hearing may deteriorate, sensitivity in the external auditory canal, taste sensitivity, xerophthalmia decrease.

Irritation of the large stony nerve (the first branch of n. faciales) leads to the development of Bing-Horton's syndrome, which is characterized by the appearance of severe pain that captures half of the head on the side of the focus, lacrimation, watery mucous discharge from the nose in combination with Petit syndrome: exophthalmos, mydriasis , expansion of the palpebral fissure.

Neuropathy of the facial nerve with peripheral paresis can also be observed with extensive supranuclear processes with damage to the anterior and posterior central gyri of the cerebral cortex. In this case, peripheral paresis is detected on the side of the lesion and symptoms of central paralysis are on the opposite side.

With a pathological focus in the region of the nuclei of the facial nerve, alternating syndromes are detected.

One of the reasons for the development of intercostal neuralgia is the herpes simplex virus. The disease is characterized by inflammation in the nerve endings and blisters on the skin along the affected nerve. Such a disease is accompanied by constant severe pain, causing a stressful state of a person, loss of appetite, provoking insomnia and reducing human activity.

Causes of herpetic intercostal neuralgia

The development of such a pathology provokes the activation of the varicella-zoster virus - the varicella-zoster virus (herpes zoster). With a decrease in protective properties human body pathogenic virus penetrates the nerve nodes, nerve cells and quickly move along the nerve fibers. Such a pathological process starts from the spine, affects the spinal nerve, is localized on the left or right side of a person. Skin rashes are formed along the nerves affected by herpes.

In most cases, herpetic neuralgia is diagnosed in people over 40 years of age. The development of the disease in children and adolescents is recorded in 10% of cases.

The virus is activated against the background of weak immunity.

The main causes of intercostal neuralgia caused by the herpes virus include:

• weakening of the human immune system;
• severe hypothermia of the body;
• transferred ARVI, influenza:
• psychological stress.

Symptoms of the disease

Symptoms of the disease develop in stages:

1. The initial stage of the occurrence of such a pathology is characterized by the appearance of burning and itching in the area chest between the ribs. The skin around the affected nerves becomes numb.
2. A strong pain syndrome develops. Pain on the nerves in the intercostal region is aggravated by movement, touch, sneezing, cooling and can be given to the shoulder region. Painful sensations may be burning, pressing, shooting or blunt in nature.
3. Bubble rashes appear on the skin in the intercostal region, filled with a clear liquid. The herpes rash spreads, the skin around the blisters swells, becomes inflamed. Pain and overthrow intensify.
4. The bubbles dry up, their surface is covered with yellow-brown crusts. The intercostal nerves are strongly irritated and sensitive to touch. In the area of ​​damaged nerve cells, constant long-term pain is felt.

Against the background of the development of the disease occur:

• limb weakness;
• headache;
• change in psychological state;
• increased blood pressure;
• insomnia;
• loss of appetite;
• increase in body temperature;
• pain in the region of the heart.

The consequence of the disease can be brain damage.

When the structure of nerve fibers is damaged by herpes, pain continues to bother a person for several years. The consequences of herpetic neuralgia include:

• damage to the human nervous system;
• development of meningoencephalitis;
• neurological syndrome;
• education or neuropathy.

Diagnosis and treatment

Diagnosis of the disease is based on the characteristic manifestations and signs of the disease. Held:

• external examination of the patient;
• laboratory blood and urine tests.

For accurate differentiation of pathology, the following are additionally prescribed:

• Ultrasound of internal organs;
• x-ray of the spine;
• electrocardiogram.

Medical medical therapy

Therapeutic measures are primarily aimed at eliminating the virus.

main goals drug therapy are the elimination of the herpes virus and the reduction of pain. For this are used:

• hormonal agents;
• anticonvulsants;
• antidepressants;
• local anesthetics;
• vitamin complexes.

Medications effective in the fight against the herpes virus are set out in the table:

Medication	Therapeutic action
"Acyclovir"	Eliminates the herpes virus
"Gabapentin"	Stops intercostal pain syndrome, prevents rash
"Famvir"	Alleviates the symptoms of neuralgia, reduces their duration
"Valtrex"	Destroys viral infection
"Diclofenac"	Relieves inflammation
"Ibuprofen"	Lowers body temperature, relieves pain
"Sedasen"	Calms the central nervous system, eliminates insomnia
"Amitriptyline"	Suppresses the perception of pain
Plaster "Versatis"	Pain reliever
"Dexamethasone"	Has anti-inflammatory and immunosuppressive effects
B vitamins	Restore the protective properties of the body

In the treatment of herpetic neuralgia in the intercostal region, physiotherapy and acupuncture have an effective analgesic effect.

If herpes occurs, the psychosomatics of the disease is more relevant than ever. After all, it is regarded as a nervous disease, and the herpes virus settles in the spinal ganglia, which excludes any possibility of overcoming the insidious disease forever.

And the disease manifests itself against the background of nervous exhaustion, during a period of weakened immunity, in stressful situations. That's why psychological reasons disease is a strong foundation of physiological suffering. The psychosomatics of herpes is associated, first of all, with strong internal experiences of a person.

Psychosomatics of labial herpes

The word herpes is based on the Greek verb herpo, which means "creeping". The reason why a herpetic infection is activated is the “creeps” of deeply hidden feelings and desires. The main theme of the disease is traced:

• separation anxiety;
• thirst for reunion;
• inexpressibility of feelings.

It has been proven that herpes on the lips occurs at a time when experiences are already behind (post-traumatic syndrome). Consider life situations in which the formation of blisters on the lips is recorded:

1. You experienced a long separation from your loved one, you haven’t kissed him for a long time, and now he is standing on the threshold of your house. When the unrest subsided, the happy ending of suffering came, on this recovery period psyche there is a "cold" on the lips.
2. It happens that you have a strong quarrel with loved ones. It is at the stage of reconciliation, friendly hugs, confessions that herpes on the lip occurs.
3. When a child experiences a lack of maternal affection and warmth, and then receives the desired kisses and hugs, then herpes immediately appears. The virus can manifest itself outwardly not only on the lips, but even on the nose.
4. Accumulated anger at someone can also cause illness. When the "steam" comes out, rashes may appear on the mucous membrane of the lips.

It is important to understand that infection occurs through contact with a virus-affected area of ​​skin or mucous membranes. The psychosomatic factor is relevant when it comes to recurrent herpes.

Psychosomatics of genital herpes

In this case, the psychology of experiencing separation and lack of love is also important. Only the background here is sexual (great preoccupation with experiences and a strong thirst for merging).

Perhaps the spouse is experiencing a long abstinence due to the absence of her husband. And upon the arrival of the husband, the wife develops herpetic eruptions in the area of ​​the labia and the vestibule of the vagina.

Manifestations of herpesvirus on the body are also called "post-trip" illness.

If you did not find the cause of your illness in the list of the above situations, then still think about the topic of separation and subsequent reunification.

For example, it happens that your loved one is sick for a long time. And every time he got better, you could get herpes. The point is not only that, on the basis of weakened immunity, the herpes virus made itself felt.

Perhaps you were so afraid of getting infected from your loved one who distanced themselves from him, did not allow themselves kisses and hugs. Here a prime example separation experiences, even when people live under the same roof.

It is believed that herpes vesicles should not be touched with hands in order to avoid its spread to other parts of the body. But in psychology there are cases when full recovery and the extinction of external symptoms when the site of the herpes lesion was touched (satisfied the need for touching).

What can be done?

If you often have recurrent herpes, and at the same time you do not observe yourself exhausted or flu-like, then think about the negative feelings that precede the appearance of herpes.

Work with these emotions and transform them (try to draw the emerging image).

Symbol-dramatic motifs perfectly cope with the problem of psychosomatics. There is an immersion in the image in which you are invited to imagine your illness. The following questions may be asked:

1. What does your disease look like?
2. What does she want to tell you?
3. What worries her?
4. Why does she want to be with you?
5. What should she be given to make her leave and never come back?

It often happens that patients pronounce dissatisfaction due to separation, the inability to find a way out for their libido.

It should be noted that shingles - herpes zoster - is based on other conflicts. Indeed, in this case, the nerve is more affected and only a little skin.

Take care of your nerves. Learn to analyze your own negative emotions. Do not lose your soul contact with the body. The herpes virus cannot be eradicated, but it can be persuaded not to create unnecessary problems for you by resorting to psychotherapy, for example.

Herpetic infection is widespread among the population. Primary contact with herpes viruses usually occurs in early childhood. As early as 3 years old, 70–90% of children have antibodies to the herpes simplex virus.

Classification. According to the localization of the lesion, they distinguish:

1) damage to the central nervous system (encephalitis, meningitis, myelitis);

2) damage to the peripheral nervous system (ganglioneuritis);

3) combined damage to the central and peripheral nervous system;

4) combined damage to the nervous system and other organs.

Herpetic encephalitis. Refers to one of the most severe and frequent forms of viral encephalitis. It occurs evenly throughout the year. In most cases, the disease is caused by the herpes simplex virus type 1. Herpesvirus type 2 is the causative agent of encephalitis in newborns, while infection occurs from mothers with active genital herpes. It often causes generalized forms of infection, when, in addition to brain damage, there are symptoms of damage to the liver, lungs, and pericardium. Perhaps the development of the disease due to the defeat of the herpes zoster virus (herpes virus type 3). The herpes virus is dermato- and neurotropic. The entrance gates are the skin and mucous membranes. At the site of introduction, the virus multiplies, inflammation occurs, focal changes in the cells of the prickly layer of the skin. In the future, viremia sets in, due to which the pathogen spreads to various organs and tissues, mainly to the liver and central nervous system. In addition, the virus enters the nerve ganglia through the nerve endings, where it persists for many years. Morphologically, encephalitis is an acute necrotic process with predominant localization of the lesion in the medial part of the temporal lobes. Around the zones of necrosis, foci of the inflammatory reaction are observed.

The disease develops acutely, with a sharp increase in body temperature, fever, headache. The meningeal syndrome is expressed moderately. Characteristically, the presence of early stage diseases of focal or generalized recurrent convulsive seizures. Violation of consciousness develops rapidly, somnolence turns into stupor and coma. Focal neurological symptoms appear, indicating damage to the temporal and frontal lobes. There are olfactory and gustatory hallucinations, anosmia, behavioral disorders, memory disorders, aphasia, hemiparesis. Perhaps the development of intracranial hypertension. Without treatment death occurs in 50-70% of cases. If the cause of encephalitis is the herpes zoster virus, then its course is more favorable. Rarely develops a coma. Clinically, encephalitis is manifested by general infectious, cerebral and focal symptoms. Quite often, stem, cerebellar syndromes are found. In the cerebrospinal fluid, moderate lymphocytic pleocytosis (50-100 per 1 mm 3) is determined, the protein content increases. On the electroencephalogram against the background of dysrhythmia, slow-wave activity occurs, as well as periodic high-amplitude fast waves.

herpetic meningitis, caused by the herpes simplex virus, may not be accompanied by damage to the mucous membranes and skin. Rarely associated with severe respiratory symptoms. Body temperature usually does not exceed 37.5 ° C. Tends to flow. Often there is a dissociation of the shell syndrome, when rigidity of the occipital muscles predominates with little severe symptom Kernig. Herpes zoster meningitis often presents with more severe symptoms. Often accompanied by skin lesions that occur on the 4-5th day after the development of herpes zoster. There is an increase in body temperature up to 38-39 ° C, severe headaches, vomiting is possible. Shell symptoms are expressed, focal neurological symptoms are often recorded. During lumbar puncture, the cerebrospinal fluid is colorless, transparent, the pressure is increased to 250–300 mm of water. Art. Lymphocytic pleocytosis, protein and glucose levels are normal.

Ganglioneuritis when affected by the herpes zoster virus, it begins as a general infectious disease - with an increase in body temperature, general weakness, and malaise. A few days later there are intense pain, paresthesia in the area of ​​one or more segments. Mainly 1-2 adjacent spinal ganglia are affected. The thoracic segments are most commonly affected, followed by the first branch of the trigeminal nerve and the cervical segments. Lesions of other localization are extremely rare. A few days after the onset of pain, papules appear on the skin and mucous membranes against the background of erythema, and then vesicles filled with serous fluid. The rash continues for several hours. They are located along one or more skin segments. When the first branch of the trigeminal nerve is involved, the pathological process can move to the cornea, which can lead to permanent visual impairment. Rashes are in the nature of a "belt" on the trunk or longitudinal stripes on the limbs. Possible damage to the crankshaft (Ramsay Hunt syndrome), which is characterized by damage to the VII and VIII pairs of cranial nerves, rashes in the external auditory canal and auricle. Gradually, the bubbles dry up, crusts form, which disappear within a few weeks, and pigmentation remains in their place. Often, neuralgic pains do not disappear after the elimination of rashes, but even intensify. They are characterized as unbearable burning, aggravated by touching the affected areas of the skin.

Diagnostics. Along with the data of anamnesis, complaints of the patient and objective clinical picture diseases, a complex of laboratory and instrumental research methods is used. If meningoencephalitis is suspected, a lumbar puncture is mandatory, in which symptoms of the inflammatory process can be detected. Informative diagnostic methods are computer diagnostics and magnetic resonance imaging, which even at an early stage of the disease can reveal inflammatory changes, edema, foci of small hemorrhages in the temporal and frontal areas. The detection of areas of low density allows us to conclude that the process is necrotic. In case of damage to the peripheral nervous system, it is necessary to conduct an electroneuromyographic study, which allows you to identify the potentials of fasciculations, a decrease in the speed of conduction along the motor and sensory fibers. Required laboratory research blood and fluid samples. It is preferable to use nucleic acid amplification methods - NAATs ( polymerase chain reaction (PCR) and real-time PCR ) . To identify specific antigens, the direct immunofluorescence reaction (DIF) and enzyme immunoassay (ELISA) are used. Also, using ELISA, specific YgM and YgG antibodies and the YgG avidity index are determined.

Treatment. Treatment must be comprehensive. The drug of choice for etiotropic therapy is the antiviral drug acyclovir (Zovirax). The drug selectively acts on the DNA of the virus, inhibiting its synthesis. In mild cases, the drug is prescribed orally 200 mg 5 times a day for 5 days or orally 400 mg 3 times a day for 5-7 days. It is possible to use famciclovir 250 mg orally 3 times a day for 5–7 days or valaciclovir 500 mg orally 2 times a day for 5–10 days. In severe cases of the disease, acyclovir is prescribed intravenously every 8 hours at a daily dosage of 30-45 mg / kg. The duration of treatment is 10-14 days. Another highly effective drug recommended for the treatment of herpetic meningoencephalitis is vidarabine. Sometimes a combined treatment regimen with both drugs is used: acyclovir is administered at 35 mg / kg 3 times a day every other day, vidarabine - 15 mg / kg 2 times a day every other day. It is possible to use a combination of acyclovir with interferon or interferon inducers. In addition, great importance is attached to pathogenetic and symptomatic therapy aimed at preventing and eliminating cerebral edema, maintaining the body's water-salt balance, eliminating the epileptic syndrome, and relieving pain.