Pazin G J, Ho M, Jannetta P J
J Infect Dis. 1978 Sep;138(3):405-9. doi: 10.1093/infdis/138.3.405.
Reactivation of herpes simplex virus was prospectively studied in patients after microneurosurgical decompression of the trigeminal sensory root, a new operation for trigeminal neuralgia in which the nerve is not sectioned. Reactivation was detected in 28 (50%) of 56 patients. Virus was cultured from oropharyngeal secretions in 25 patients, and 21 patients developed cutaneous herpetic lesions. Seven patients had positive throat-wash (TW) cultures but did not develop lesions, and the converse occurred in three patients. Eighteen patients had both positive TW cultures and herpetic lesions. In eight of nine instances in which a sequence was determinable, TW cultures were positive before lesions developed. A history of recurrent herpes labialis was associated with a higher risk of developing reactivation postoperatively (59.4% vs. 31.6%, P less than 0.05). These observations suggest that minimal stimulation or inapparent trauma to the trigeminal sensory root is sufficient to activate latent herpes simplex virus in humans. These patients provide unique opportunities to study immunologic responses and therapeutic measures.
对三叉神经感觉根进行显微神经外科减压术后的患者,前瞻性研究了单纯疱疹病毒的再激活情况。三叉神经感觉根显微神经外科减压术是一种治疗三叉神经痛的新手术,术中神经不被切断。56例患者中有28例(50%)检测到病毒再激活。25例患者的口咽分泌物中培养出病毒,21例患者出现皮肤疱疹病变。7例患者咽拭子(TW)培养阳性但未出现病变,3例患者出现相反情况。18例患者TW培养阳性且有疱疹病变。在9例可确定顺序的病例中,有8例在病变出现前TW培养呈阳性。复发性唇疱疹病史与术后发生再激活的风险较高相关(59.4%对31.6%,P<0.05)。这些观察结果表明,对三叉神经感觉根的最小刺激或隐匿性损伤足以激活人类潜伏的单纯疱疹病毒。这些患者为研究免疫反应和治疗措施提供了独特的机会。