• World Neurosurg · Sep 2024

    Predictive factors for herpes simplex virus reactivation in patients with trigeminal neuralgia after surgery.

    • Zihao Zhang, Qingpei Hao, Gang Wu, Jia Ouyang, Wentao Zheng, Haoqi Zhou, Yezu Liu, Zeyu Miao, Guangbiao Qin, and Ruen Liu.
    • Department of Neurosurgery, Peking University People's Hospital, Beijing, China.
    • World Neurosurg. 2024 Sep 5.

    ObjectiveThis study aimed to investigate the predictive factors associated with the reactivation of herpes simplex virus (HSV) in patients with trigeminal neuralgia after surgery and to determine whether there is a correlation between reactivation and surgical efficacy.MethodsThis study included 190 patients who underwent surgery between January 2020 and December 2021. Postoperative HSV reactivation was defined as the presence of perioral or gingival herpes and herpes labialis within 1 week postoperatively. Logistic regression analysis was used to evaluate clinical characteristics as potential predictors of HSV reactivation. Additionally, Spearman's rank correlation coefficient was used to determine any correlation between the postoperative Barrow Neurological Institute pain intensity score and HSV reactivation.ResultsOf the 190 patients, 56 (29.5%) experienced postoperative HSV reactivation. Both univariate and multivariate analyses identified several significant predictors of HSV reactivation, such as a history of HSV infection, previous trigeminal nerve-damaging surgery, the use of internal neurolysis as a surgical technique, and an operation time of ≥25 minutes. No significant correlation was found between HSV reactivation and pain relief, as measured by Barrow Neurological Institute scores.ConclusionsHSV reactivation was observed in a considerable proportion of patients with trigeminal neuralgia. Long operative times (≥25 minutes), the use of internal neurolysis as a surgical technique, a history of HSV infection, and previous trigeminal nerve-damaging surgery were identified as risk factors. Further research is needed to optimize surgical procedures and develop targeted management protocols to reduce the risk of HSV reactivation.Copyright © 2024 Elsevier Inc. All rights reserved.

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