Method for treating herpetic lesion of vestibular, spiral, trigeminal and geniculate ganglia

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vestibular and auditory disorders, trigeminal nerve's neuralgia and peripheral paresis of facial nerve of herpetic etiology. The method deals with introduction of an antiherpetic preparation followed by immunomodelling therapy with the use of polyoxidonium. Moreover, after treating with antiherpetic preparation before introducing polyoxidonium it is necessary to conduct additional successive therapy: with preparations of trophic action as milgamma or neuromultivit at simultaneous introduction of antioxidant, then comes intratissue injection of cerebrolysine being behind the top of mastoid process.

EFFECT: the innovation enables to decrease the quantity of relapses due to stopping the development of herpes simplex virus, restore conductivity along nervous fiber and improve endoneural circulation.

3 cl, 3 ex

 

The invention relates to medicine, namely to the treatment of vestibular and auditory disorders, trigeminal neuralgia and peripheral paresis of the facial nerve herpetic etiology.

It is established that chronic herpes infection refers to a common, socially significant diseases. The diversity of clinical manifestations of persistent herpes infection, recurrent nature of the flow, the possibility of its spread almost all known transmission routes has allowed to carry herpes infection in a group of diseases that determine the future of all infectious diseases [1]. A well-known fact that the herpes simplex virus (HSV) for life peretiraet in sensory nerve ganglia with periodic exacerbation of clinical symptoms [2]. Among the many problems associated with HSV, special attention should be given to treatment and relapse prevention of exacerbations of herpes infection [3].

There is a method of treatment of herpetic lesions of the vestibular, auditory, trigeminal and geniculate ganglia [3, 4], which consists in prescribing antiviral drugs, such as famciclovir and acyclovir. The disadvantage of this treatment is that the reception of acyclic nucleosides has no effect on the frequency of subsequent reci ivov, because these drugs do not lead to eradication of herpes simplex virus.

Closest to the claimed method of treatment is the method [5], including the appointment of Antiherpes virus effect means, for example, famciclovir, and holding immunomodulatory therapy with polyoxidonium, cycloferon, Viferon, neovir. This method of treatment allows to reduce terms of recurrence and extend miraculousy period [6]. The disadvantage of this method is that there is no correction of oxidative stress: disorders of conduction of a nerve fiber and trophic dysfunction, reduction of microcirculation.

The aim of the invention is to increase the efficiency of treatment by reducing the number of relapses, halting the spread of HSV, restoration of conduction of a nerve fiber, the improvement endoneural blood flow.

This objective is achieved in that in the method for the treatment of herpetic lesions of the vestibular, spiral, trigeminal and geniculate ganglia, including the appointment of Antiherpes virus effect means, for example, famciclovir, and subsequent together with immunomodulating therapy with polyoxidonium, according to the invention after treatment antigerpeticski means sequentially enter the following medications: trophic effect, antioxidant effect, with integrated metabolicescom and vasoactive action Mexidol; with impact on the processes of plasticity with a multimodal effect on the metabolism of brain - Cerebrolysin, with the introduction of Cerebrolysin spend interstitial behind the top of the mastoid process.

As a drug with trophic action designate milgamma, pyromellitic. As a drug with antioxidant appoint thioctacid T, tagammu, Berlition.

A feature of the invention lies in the fact that the appointment of agents with antioxidant and trophic action after the course Antiherpes virus effect of therapy provides a neuroprotective effect, and subsequent interstitial introduction of Cerebrolysin behind the top of the mastoid process helps to improve microcirculation in the area of introduction. The implementation of immunomodulatory therapy at the final stage of treatment can increase miracidium period. In the diagnosis of isolated lesions of herpes simplex virus vestibular (vestibular neurons), spiral (sensorineural hearing loss), trigeminal (trigeminal nerve) and geniculate ganglia (peripheral facial nerve paresis) or their combination is prescribed taking famciclovir 0.25 g and 0.5 g 3 times a day or 0.75 1 g once a day for 7 to 10 days.

8-11 day begin injections milgamma 2 ml intramuscularly for 10 days, after which it is infusion of thioctacid 600 mg (24 ml) in 200 ml of 0.9% isotonic sodium chloride solution, slowly 10-20 days. On 17-20 day is interstitial introduction of Cerebrolysin in 2-5 ml behind the top mastoid 10 days. On 26-29 day appointed polyoxidonium 6 mg intramuscularly daily for 5 days, then 2 times per week (course of 10 injections).

Examples of specific implementation of the proposed method of treatment.

Example 1. Patient S., 53 years. The diagnosis of Vestibular neurons to the left herpetic etiology (lesion of the vestibular ganglion).

Held: Famciclovir 0.25 g 3 times a day for 7 days, then on the 8th day of injections milgamma 2 ml intramuscularly and at the same time infusion of thioctacid 600 mg (24 ml) in 200 ml of 0.9% isotonic sodium chloride solution slowly to 10 days. On the 17th day was held interstitial introduction of Cerebrolysin 2 ml behind the top mastoid No. 10. On the 26th day appointed polyoxidonium 6 mg intramuscularly every other day No. 5, further 2 times a week (course of 10 injections). After treatment vertigo, ataxia and autonomic manifestations were absent. Observation 2 years, similar violations were observed.

Example 2. Patient T., aged 54. Diagnosis: Kohleovestibulyarnye dysfunction on the right. Peripheral paresis of the right facial nerve herpetic etiology (vestibular lesion, spiral talentoso ganglia).

Held: Famciclovir 0.25 g 3 times a day for 7 days, then on the 8th day of injections milgamma 2 ml intramuscularly and at the same time infusion of thioctacid 600 mg (24 ml) in 200 ml of 0.9% isotonic sodium chloride solution slowly to 10 days. On ottke was conducted interstitial introduction of Cerebrolysin 2 ml behind the top mastoid No. 10. On the 26th day appointed polyoxidonium 6 mg intramuscularly every other day No. 5, further 2 times a week (course of 10 injections). After treatment vertigo, ataxia and autonomic manifestations were absent. Hearing in norm according to audiometry. Fully recovered function of the facial nerve. Observation 1 year, similar violations were observed.

Example 3. Patient K., 31. The diagnosis of Vestibular dysfunction on the right. Neuralgia of the trigeminal nerve on the right herpetic etiology (lesion of the vestibular and trigeminal ganglia).

Held: Famciclovir 0.25 g 3 times a day for 7 days, then on the 8th day of injections milgamma 2 ml intramuscularly, and at the same time infusion of thioctacid 600 mg (24 ml) in 200 ml of 0.9% isotonic sodium chloride solution slowly to 10 days. On the 17th day was held interstitial introduction of Cerebrolysin 2 ml behind the top mastoid No. 10. On the 26th day appointed polyoxidonium 6 mg intramuscularly every other day No. 5, further 2 times a week (course of 10 injections). After the factors of treatment dizziness and autonomic manifestations are absent. Pain during the first and second branches of the trigeminal nerve were observed. Observation 2 years, trigeminal neuralgia resumed during colds. Thus, the proposed method allows to stop the spread of herpes simplex virus during vestibular lesion, spiral, trigeminal and geniculate ganglia, to restore the conductivity of the nerve trunks preddure-cochlear, facial and trigeminal nerves, and improve the microcirculation of the affected area and reduce the number of relapses and increase miracidium period of chronic recurrent herpetic infection.

A new method for the treatment of herpetic lesions of the vestibular, spiral, trigeminal and geniculate ganglia can be applied in outpatient and inpatient treatment of patients with vestibular dysfunction herpetic etiology, with kohleovestibulyarnye dysfunction herpetic etiology, trigeminal neuralgia, herpetic etiology, facial paresis herpetic etiology.

Sources of information

1. Nalimov T.A. Viral infection in ENT practice. / Casaliva, Yegorova // Proceedings of the V scientific-practical conference "Modern technologies in medicine". - Nyagan, 2003. - P.35-36.

2. Barinskiy IVAN Etiology chronice the fir viral neuroinfections. / Ipparently, Akhobadze. - M.: Medicine, 1984. - 168 C.

3. Babiak VI Neuropathology: a Guide for physicians. / Viebig, Vurgaftman, Ahankara. - SPb.: Hippocrates, 2002. - 728 S.

4. Nalimov T.A. Rehabilitation with the defeat of ENT organs Herpes Zoster. / Casaliva, Yegorova, Evecon // Problems of rehabilitation in otorhinolaryngology. Proceedings of all-Russian conference with international participation. - Samara, 2003. - S-536.

5. Samghin M.A. herpes simplex (Dermatological aspects). / Massagen, A.A. Haldin. - M: MED Presentors, 2002. - 160 S.

6. Federal guidance on the use of drugs (formulary system).- M: ECHO, 2004. Edition V. - 944 S.

1. A method of treating herpetic lesions of the vestibular and/or spiral, and/or trigeminal and/or geniculate ganglia, including the introduction of Antiherpes virus effect means and subsequent together with immunomodulating therapy with polyoxidonium, characterized in that after treatment Antiherpes virus effect means prior to the introduction of polyoxidonium perform sequential treatment with trophic steps, which use milgamma or neuroactivity, with simultaneous introduction of an antioxidant, and then perform interstitial introduction of Cerebrolysin behind the top of the mastoid process.

2. The method according to claim 1, otlichayushiesya, as a drug with antioxidant appoint thioctacid T.

3. The method according to claim 1, characterized in that the quality of the drug with antioxidant designate tagammu.

4. The method according to claim 1, characterized in that the quality of the drug with antioxidant appoint Berlition.



 

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