Chronische Gesichtsschmerzen

Herpes Simplex Virus (HSV) macht Entzündung im Trigeminus

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Kategorie: Chronische Schmerzen

Erstellt am Dienstag, 27. September 2011 05:25

Geschrieben von Joachim Wagner

Zugriffe: 1135

A 61-year-old woman had five episodes of myelitis and was diagnosed as multiple sclerosis (MS). She had an erup- tion on her left lower lip and the diagnosis of herpes labialis was confirmed by a dermatologist (Picture 1a). Sensory dis- turbance in the left mandibular nerve region was observed. Brain  MRI  revealed  a  T2-hyperintense  linear  lesion  along the  left  intramedullary  trigeminal  nerve  root  (Picture  1b). This patient was infected with HSV confirmed by ELISA. We previously reported 5 patients with MS who had pe- culiar MRI lesions along the pontine intramedullary trigemi- nal nerve root with various ipsilateral facial sensory mani- festations (1).  We  supposed  that  those  lesions  might  have been virally induced because they were similar to demyeli- nating lesions induced by experimental inoculation of HSV on the  corneas  of  mice (2). The  present  patient  may  be  a rare example of clinical manifestations of reactivated HSV in both proximal and distal portions of trigeminal nerve. The authors state that they have no Conflict of Interest (COI). Acknowledgement We thank Drs. Ohito Tano, Tatsuro Misu, Masashi Aoki, and Kazuo Fujihara for useful discussion. We also thank Mr. Brent Bell for reading our manuscript.

References

1. Nakashima I, Fujihara K, Kimpara T, Okita N, Takase S, Itoyama Y. Linear  pontine  trigeminal  root  lesions  in  multiple  sclerosis: clinical and magnetic resonance imaging studies in 5 cases. Arch Neurol 58: 101-104, 2001.

2. Itoyama Y,  Sekizawa T,  Openshaw  H,  Kogure  K,  Goto  I. Early loss of astrocytes in herpes simplex virus-induced central nervous system demyelination. Ann Neurol 29: 285-292, 1991.

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