[Cerebrovascular syndromes in ocular herpes zoster convalescents (review of the literature)].
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Biomedical subjects
Publications and source records attributed to Iu K Smirnov.
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Long-term follow-up of 2000 patients with herpes zoster (HZ) in the department of viral neuroinfections as well as special HZ studies provided evidence for comprehensive evaluation of HZ pathogenesis. In addition to peripheral nervous system involvement, HZ is shown to cause systemic disorders typical for neuroviral infections. The principles of adequate pathogenetic therapy are validated. It is believed that relevant pathogenetic studies contribute to the development of general pathology.
Clinical investigation of 42 children with infectious-allergic polyradiculoneuropathy (Guillain-Barre syndrome) revealed that pareses of lateral ocular muscles were present but in patients older than 5 years. The pathogenesis and differential diagnosis between Guillain-Barre and Tolosa-Hunt syndromes is discussed.
A child aged 4 years and 10 months with congenital immunodeficient status (agammaglobulinemia) developed an acute viral disease combined with torpid arm paralysis, which is considered as paralytic zoster. This disorder is differentiated from the spinal form of poliomyelitis.
The authors analyse the inpatient findings accumulated from 2,179 observations on herpes zoster cases for 10 years. The clinico-epidemiological characterization of herpes zoster patients as the potential source of chickenpox infection is presented. The clinical data speak for the droplet transfer of the agent (varicella zoster virus) in this infection, which has permitted the formulation of exact practical recommendations of quarantine and isolation measures in the focus of herpes zoster.
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The authors examined thirty-two patients with tick-borne erythema annulare which developed after tick bites. The disease had a peculiar nosological form and was characterized by tick sticking, an incubation period, the presence in the majority of patients of the temperature reaction and manifestations of general infection in the acute period, the development of migrating erythema annulare, frequent lesions (26 patients) of the nervous system in the form of the radicular symptoms, serous meningitis, pareses of the facial muscles, etc. Electrophysiological examination of patients revealed marked changes. Serological tests for tick-borne encephalitis proved negative. The time-course of the disease in the majority of patients was favourable. The disease was characterized by all features typical of an infection lesion, with neurological disorders being predominant, which requires further investigation.
Two clinical cases of post-poliomyelitic progressive amyotrophy (PPA) are described. One patient had serological tests of the blood and cerebrospinal fluid for viruses of poliomyelitis, measles, simple herpes and tick-borne encephalitis which were negative. The authors suggest that PPA develops in patients with a peculiar genetic predisposition and altered homeostasis and is a degenerative-dystrophic disease of the motor nerve.
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Fifty patients with early stages of herpes zoster (23 patients with the ophthalmic form and 27 with other localizations of the lesion) were treated with levamisol, since it was assumed that the disease is caused by the activation of the varicellazoster virus in association with cellular immunodeficiency. The control group consisted of 63 subjects, including 26 with the ophthalmic form. Beneficial results such as faster skin clearance and fewer days of hospitalization suggest that this agent should be recommended for combined treatment of patients suffering from herpes zoster.
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The symptoms and the course of herpes zoster are analyzed in 85 children aged 5 months to 15 years. Many systems of the body were shown to be involved in the process of the disease which is characteristic of neuroviral infections. The authors postulate the etiologic unity of chicken pox and herpes zoster as two clinical forms of the same epidemic process. The questions of treatment are outlined.
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CSF was studied in 110 patients with herpes zoster. The whole complex of symptoms helped to diagnose serous meningitis in 62% of cases and so-called "asymptomatic meningitis" in 18% of cases. CSF cells were characterized by lymphocyte transformation and the presence of antigen to Varicella zoster virus determined by the fluorescent antibody method. Specific antibodies titer appeared to be at zero or minimal level. The disease pathogenesis is discussed.
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The blood serum of patients with disseminated sclerosis and polyradiculoneuritis was tested for gliotoxic effect in organ cultures of the brain of newborn cotton rats (Sygmodon hispidus). This effect was revealed in 18 out of 25 patients with disseminated sclerosis and in 9 out of 16 patients with polyradiculoneuritis. As for other diseases the gliotoxic effect was observed only in 3 out of 41 patients examined. The data obtained confirm the significance of the allergic mechanisms in the pathogenesis of demyelinization. It is suggested that the test for the serum gliotoxic effect should be used as a diagnostic criterion of the process activity in patients with disseminated sclerosis.
Clinical examination of 83 patients with generalized herpes zoster has given the authors grounds to regard this disease as a result of activation of latent varicella-zoster virus. This assumption was confirmed by the results of indirect hemagglutination inhibition tests with 37 serum specimens taken from 18 patients. Treatment with antibiotics, the drug proper-myl, and by dehydration was the more effective, the earlier the patients were admitted to the clinic. Dehydration, proper-myl and combination of chloramphenicol with dehydration produced a more beneficial effect than the antibiotic alone. Five patients died. Problems of pathogenesis are discussed.