Detection of herpes viruses in patients with classical trigeminal neuralgia

Abstract

A comparison of the presence frequency of herpes viruses HSV1/2, VZV, HHV-6, HHV-7, EBV, CMV was conducted in 430 patients with classical trigeminal neuralgia (TN) using RT PCR method. In the venous blood of patients with paroxysmal pain syndrome (TNP) and persistent background pain (TNB), herpes viruses were detected in 36.3% (97/267) and 80.4% (131/163) cases, respectively. The effectiveness of microvascular decompression and long-term outcomes were assessed depending on the presence of herpes viruses. Pain syndrome completely regressed in 404 out of 430 patients (93.9%), partially in 25 patients (5.8%), and persisted in 1 patient (0.2%). In TNB group, pain recurrence and partial regression were observed more frequently (20.2% (34/163) and 12.8% (21/163), respectively) if compared to TNP group (1.8% (5/267) and 1.5% (4/267), respectively). Complete pain regression in TNB group was less than in TNP group: 86.5% (141/163) and 98% (263/267), respectively. The presence of herpes viruses in patients with TN, a higher frequency of detection of herpes viruses, as well as a higher percentage of patients with recurrence of pain in TNB versus TNP group suggest a potential role of herpes viruses in the development of pain syndrome. Thus, studying herpes viruses in the blood could be recommended for improving the diagnostics and therapy of patients with classical TN.