Ganglionitis is an inflammatory disease. The name of the pathology comes from the anatomical ganglion, which means “nerve node” and the medical suffix -itis, which indicates the presence of an inflammatory process.
That is, ganglionitis is an inflammation of the nerve node, which in medical terminology is called a ganglion. There are many such nodes in the human nervous system and each is responsible for its own area.
The inflammation can be isolated - only one nerve node is affected - this is ganglionitis. But it is possible that several nodes can be affected at once - this is polyganglionitis.
The local area of the body, which is affected by the inflamed nerve ganglion, loses sensitivity (paresthesia), a burning sensation and crawling sensation occurs. The accompanying pain is burning.
Inflammation of the ganglia is most often associated with infections. Dangerous complications. As an example, there is atrophy of the nerves associated with the inflamed nodes. If left untreated, the likelihood of complications is high.
Ganglionitis - what is it?
Ganglionitis is an inflammatory disease that affects one of the nerve nodes (ganglia) of the sympathetic nerve trunk. When several nodes are affected, the development of polyganglionitis, truncite or trunculitis is noted.
Also, the development of ganglionitis can be combined with damage to peripheral nerve fibers (ganglioneuritis) or spinal cord roots (ganglioradiculitis).
The main symptoms of ganglionitis depend on the location of the inflammatory process.
However, if any ganglion is affected, ganglionitis leads to the appearance of vasomotor, secretory and trophic disorders in the affected area. Therefore, with any type of ganglionitis, the appearance of intense pain, impaired sensitivity in the affected area, swelling, itching, burning of the skin, as well as severe sweating are noted.
What is a ganglion
To better understand what is happening, it is worth at least taking a closer look at the structure and functions of the ganglia.
As already noted, a ganglion is a nerve node. Perhaps the expression “bundle of nerves” refers precisely to this formation.
Without going into details, we note that the human nervous system is a very complex system. Even a non-specialist understands that it is almost impossible to control all complex human actions in everyday life from one center.
It is easier to have a distributed control system with localization of mini-centers in the area of concentration of muscles performing specific tasks. These mini-centers are the nerve nodes - ganglia.
Let's look at hand control. The figure shows the location of several ganglia (dorsal wrist ganglion and digital ganglia). Yes, these ganglia in the picture are in an inflamed state. Moreover, the digital ganglia are shown with cystic formations.
In this case, the locations of the ganglia are shown, that is, the places where you can see the presence of an inflammatory process in the nerve ganglia when pain appears in the hand. Visually, inflammation manifests itself as swelling.
For reference. The ganglion itself is a collection of neurons placed in a protective capsule of connective tissue and auxiliary cells of the nervous tissue (glial cells). Such a node is a concentrator and distributor of nerve impulses. That is, it controls a specific local area.
There are many such nerve nodes. Everyone controls their own area.
Now imagine that for some reason the control center in some area of the body becomes inflamed (ganglionitis). Naturally, this area ceases to function normally.
Reasons for the development of ganglionitis
The main causes of inflammation of the nerve ganglia include acute infectious diseases, severe metabolic disorders, trauma, severe intoxication and neoplasms that compress the nerve ganglia.
Infectious causes of ganglionitis are most common. Ganglionitis can develop against the background of:
- herpes zoster;
- typhoid fever;
- dysentery;
- measles, scarlet fever;
- otitis, tonsillitis;
- syphilis;
- flu;
- brucellosis;
- meningitis.
Recurrent inflammatory lesions of nerve ganglia and fibers often develop in patients with HIV infection.
In some cases, damage to the nerve ganglia develops in patients with hepatitis C (with this type of hepatitis, extrahepatic manifestations associated with an autoimmune inflammatory process in the body are often found).
Intoxication causes of the development of ganglionitis include alcohol, drug and infectious intoxication, poisoning with industrial poisons and chemicals, poisoning with poisonous plants, snake and spider bites.
Ganglionitis can also occur against the background of severe osteochondrosis, radiculitis, diabetes mellitus (especially with decompensated course or development of diabetic polyneuropathy), vertebral displacement, traumatic nerve damage, long-term treatment with glucocorticosteroids.
Hypothermia, sudden climate change, trauma, and worsened mental disorders can be provoking factors.
Classification of ganglionites
According to severity, ganglionitis is divided into mild, moderate and severe. Depending on the etiological factor in the development of the inflammatory process in the ganglion, herpetic, intoxication, post-traumatic, tumor and infectious ganglionitis are distinguished.
Important. Although herpes is also an infection, herpetic ganglionitis and other ganglion infections are classified as two different types of ganglionitis. This is due to the difference in the clinical picture and further treatment of the disease.
Depending on the location of the inflammatory process, lesions are distinguished:
- pterygopalatine (Slader syndrome, ganglionitis of the pterygopalatine ganglion),
- ciliated (Oppenheim syndrome),
- geniculate (Ramsay Hunt syndrome),
- ear (Frey's syndrome),
- submandibular, sublingual,
- trigeminal (gasserian),
- superior cervical and stellate ganglion.
Treatment
Treatment is etiological: for inflammatory processes - antibiotics and desensitizing agents, for tumors - surgery, etc. Complex therapy includes pathogenetically targeted and general strengthening agents, drugs that reduce the excitability of vegetative formations: ganglion blockers (pachycarpin, gangleron, etc.) "neuroleptics ( aminazine, triftazine, etc.). Physiotherapy is recommended: Bernard currents, ultrasound therapy, ion-galvanization and novocaine blockades, segmental ultraviolet irradiation and low-temperature mud, radon, hydrogen sulfide and salt baths. Neurosurgical intervention (see Ganglectomy, Sympathectomy) is indicated only in severe cases.
Forecast
favorable for life, but the disease in some cases lasts a long time, and the ability to work is reduced.
Prevention
carried out taking into account the role of primary etiological factors.
Bibliography:
Grinstein A. M. and Popova N. A. Vegetative syndromes, M., 1971; Markelov G.I. Diseases of the autonomic nervous system, Kyiv, 1948; Rusetsky I. I. Autonomic nervous disorders, M., 1958; Chetverikov N. S. Diseases of the autonomic nervous system, M., 1968.
I. A. Dmitriev.
Gagnlionitis - symptoms
For reference. Depending on the location, cause and severity of the inflammatory process, the symptoms of ganglionitis may vary.
At the same time, with all types of ganglionitis the appearance of:
- pronounced pain in the area of innervation of the affected ganglion;
- intense itching and burning of the skin over the inflamed nerve ganglion;
- severe swelling and inflammatory hyperemia (redness) of the skin over the affected ganglion;
- increased sensitivity to external stimuli;
- intense sweating;
- local (inflammation in the area) and general increase in temperature (in severe cases, severe fever, chills, and intoxication may occur);
- malaise, weakness, weakness, lethargy;
- atrophy of innervated muscles and limited mobility in joints.
Ganglionitis of the pterygopalatine ganglion
Ganglionitis of the pterygopalatine ganglion is an inflammation of the ganglion responsible for the functioning of the facial muscles.
A special case of inflammation of this node is called Slader syndrome (named after the American otolaryngologist). Slader syndrome is characterized by pain in the eye. However, the general case of ganglionitis of the pterygopalatine ganglion is broader. The generalization is based on the structure of the ganglion.
The node is located in the pterygopalatine fossa and is formed from three nerve roots:
- somatic (trigeminal nerve);
- parasimatic (facial nerve);
- sympathetic (plexus of the carotid artery, connected with the ear, cervical nodes, nerve endings of the skull).
In addition to the main symptoms characteristic of all ganglionitis, when the pterygopalatine node is affected, intense pain appears in the orbit, upper and lower jaw, nasal cavity, temporal and occipital region, as well as in the auricle.
Often, pain with ganglionitis of the pterygopalatine ganglion spreads to the shoulder, forearm and hand.
For reference. The affected side is characterized by the appearance of severe swelling of the face, severe sweating and constant lacrimation. Also characteristic is the constant secretion of mucus from the nostril on the affected side.
Ganglionitis of the pterygopalatine ganglion occurs in paroxysms. The duration of an attack can range from ten minutes to several days. During an attack, there is a sharp increase in all symptoms, the appearance of intense pain, an attack of dizziness, severe redness of the face, redness of the eyes, the appearance of profuse sweating, massive discharge of mucus from the nose, frequent sneezing and active lacrimation.
Also, ganglionitis of the pterygopalatine node may cause itching and burning, pain, dryness and pain in the eyes, ringing in the ears and toothaches.
Attacks most often develop at night.
Ganglionitis of the ear node
Involvement of the ear node is rare. This pathology is also called Frey's syndrome or auriculotemporal hyperhidrosis.
Most often, Frey's syndrome occurs after surgical removal of tumors of the parotid glands, as a late postoperative complication. Less commonly, the cause of the development of ear ganglionitis is traumatic brain injury.
For reference. The disease is characterized by a significant variety of clinical symptoms. All manifestations of Frey's syndrome are localized primarily in areas innervated by the auricular and auriculotemporal nerves.
The most common symptoms of ear ganglionitis include:
- mild, intermittent pain in the parotid area;
- severe redness of the skin in the parotid area and the appearance of intense sweating during meals;
- sensation of heat, itching or burning in the parotid area.
Sometimes there is increased salivation and tinnitus. In rare cases, pain may spread to the neck and shoulder.
Ganglionitis of the geniculate ganglion
Ramsay Hunt ganglionitis is a specific, rare complication of herpes zoster (herpes zoster). Based on the name of the primary disease, the complication is also called post-zoster syndrome.
For reference. Ganglionitis of the geniculate ganglion develops in cases where reactivation of herpes zoster is accompanied by damage to the ganglia of the 8th cranial nerve (CN) and the geniculate ganglion of the 7th pair of cranial nerves.
The main manifestations of Ramsay Hunt ganglionitis include:
- unilateral constant or paroxysmal periodic pain localized in the ear area (sometimes the pain can radiate to the face, back of the head and neck);
- specific herpetic rashes in the area of innervation of the intermediate nerve (skin of the external auditory canal, auricle, soft palate);
- decreased taste sensitivity of the tongue on the affected side.
facial nerve neuritis , paresis or paralysis of facial muscles, dizziness , horizontal nystagmus, and impaired secretory activity of the salivary and lacrimal glands on the affected side may be observed
Ganglionitis of the cervical nodes
For reference. Ganglionitis of the cervical ganglion develops mainly against the background of infections (acute or chronic tonsillitis, herpes infection, influenza, mumps) and severe intoxication.
Ganglionitis of the cervical nodes manifests itself primarily as an intense pain syndrome. The pain is paroxysmal in nature. The duration of the attack can vary from 3-4 minutes to 1-2 days.
When the upper cervical ganglion is affected, the pain is localized mainly in the head and neck area. Sometimes the pain can radiate to the back of the head, face, shoulder and forearm.
Also noted is the development of Horner's syndrome , severe tachycardia (pain in the heart may be noted), shortness of breath, weakness of the arm muscles and facial muscles on the affected side.
Nasal congestion, impaired secretion of the salivary and lacrimal glands on the affected side, and redness of the eyes are often noted.
Ganglionitis of the stellate ganglion
For reference. The main manifestation of inflammation of the stellate ganglion is paroxysmal pain in the neck and upper chest. The duration of an attack can range from several hours to a day.
The epicenter of pain is located on the inner side of the anterior edge of the sternocleidomastoid muscle. Often the pain radiates to the arm.
Manifestations
The symptoms of ganglionitis will depend on its cause. But each type is characterized by such general manifestations as burning pain, which can be paroxysmal, and severe itching in the area of the affected area. Paresthesia, which is a tingling or numbness sensation in the skin over the affected ganglion, may also develop.
Inflammation of a herpetic nature is accompanied by a rash of blisters, the touch of which causes pain. The same pain will occur in the area of the spinous processes of the vertebrae if you try to palpate them. The functioning of internal organs may be disrupted due to damage to the nerve nodes that ensure their uninterrupted functioning. The skin above the affected ganglion itself also changes. It changes color, and in more severe cases, ulcers may form on it. The function of thermoregulation and sweating is disrupted, and swelling of the subcutaneous tissue begins. The muscles that are located nearby begin to weaken and lose their tone. Reflexes also decrease, joints become stiff. If the disease affects the cervical ganglia, then the same symptoms begin to appear on the face, neck and in different places of the head.
With the development of inflammation in the area of the stellate node, pain in the upper half of the chest and false angina may occur.
Ganglionitis of the gasserian ganglion develops due to a decrease in the body's defenses. This disease is much more severe than herpetic ganglionitis, and rashes most often occur in the trigeminal nerve area - on the face, near the eyes. In this case, there is a high risk of developing keratitis, that is, inflammation of the cornea. Other symptoms include photophobia and darkening of the surface layers of the skin. The rashes themselves look like small, barely visible dots.
Ganglionitis of the pterygopalatine ganglion is characterized by acute pain in the eye area and around the orbits, in the area of the upper jaw and root of the nose, and less often in the area of the lower jaw. In this case, the pain can spread to the temples and even to the arms.
Inflammation of the geniculate ganglion is characterized by inflammation and herpetic rashes in the ear area and pain. Sometimes there may be complaints of dizziness. When the lumbar and lower thoracic nodes are affected, dysfunction of the pelvic and abdominal organs is observed.
Ganglionitis - ganglioneuritis
The similar names ganglionitis and ganglioneuritis reflect essentially different pathologies.
Let us recall that ganglionitis is an isolated inflammation of the nerve ganglion. That is, only those very encapsulated roots that are part of the “ball of nerves” are affected. And with ganglioneuritis, the nerve trunks associated with the ganglion are also affected.
The geniculate and pterygopalatine nodes are most susceptible to ganglioneuritis.
For reference. The main cause of ganglioneuritis is infection. The disease can develop against the background of erysipelas, herpes infection, scarlet fever, measles, mumps, diphtheria, influenza, syphilis, tuberculosis, and untreated odontogenic infections.
The symptoms of ganglioneuritis are similar to the symptoms of ganglionitis and directly depend on the location of the inflammatory process.
The main symptoms of ganglioneuritis include intense burning and throbbing pain, swelling and sensory disturbances, redness of the skin in the affected area.
When the upper cervical ganglion is affected, widening of the palpebral fissure, exophthalmos, increased lacrimation and sweating are observed.
Inflammation of the lower cervical ganglion is characterized by the appearance of muscle weakness in the arm on the affected side, tachycardia, breathing problems, and chest pain.
Inflammation of the thoracic and lumbar nodes is accompanied by trophic disorders in the legs, pain in the buttocks, lower back and legs, and muscle weakness. Erectile disorders and dysuric disorders are possible.
The most common complications of ganglioneuritis are:
- postherpetic neuralgia;
- weakening of the muscles in the affected area.
If left untreated, ganglioneuritis can lead to the development of encephalitis.
Causes
Inflammation of one or more ganglia cannot appear just like that. This is usually caused by other diseases, the most common of which are:
- Flu.
- Rheumatism.
- Malaria.
- Angina.
- Herpes zoster.
- Tumors.
- Injuries.
- Intoxication of the body.
But most often the cause of this disease is viruses, so according to statistics, it develops against the background of a herpetic infection. If ganglionitis occurs in the area of the pterygopalatine node, then the main causes here can be considered sinusitis, rhinitis in the chronic stage, pharyngitis, tonsillitis, purulent otitis.
Why is ganglionitis dangerous?
In the absence of timely treatment, the following are possible:
- atrophy of the affected nerve,
- spread and progression of infection,
- addition of a secondary bacterial infection,
- development of myositis, myelitis,
- paresis of the affected muscles.
The greatest danger is represented by herpetic ganglionitis, since they can be complicated by:
- ophthalmoherpes;
- encephalitis, meningitis, meningoencephalitis;
- myelitis, encephalomyelitis;
- hemiparesis, vasculitis of cerebral vessels;
- granulomatous angiitis;
- cerebral thrombosis and stroke;
- acute retinal necrosis;
- progressive multifocal leukoencephalopathies;
- postherpetic neuralgia.
Inflammation of the nerve nodes associated with the control of the skin may lead to the development of trophic disorders (changes in skin color and pigmentation, thinning and ulceration, swelling of the subcutaneous tissue), regional sweating and thermoregulation may be disrupted.
For reference. When the ganglia responsible for the functioning of internal organs become inflamed, unpleasant consequences may arise in the form of disruption of the functioning of these organs.
Diagnostics
In most cases, ganglioneuritis is diagnosed primarily on the basis of the patient’s pronounced complaints, as well as the clinical symptoms identified in him. Of course, diagnostics in neurology cannot be done without a thorough collection of anamnesis - recent viral or bacterial infections that a person has suffered, exacerbations of chronic pathologies.
After this, the specialist proceeds to examination - thermometry, auscultation, palpation. Inflammation of the ganglia will be characterized by severe pain in the tissues directly above the source of inflammation, changes in color and temperature. Changes during ganglionitis will also affect heart rate and blood pressure - their parameters will be worse than in a person in full health.
Differential diagnosis of ganglioneuritis with diseases of the heart, stomach, and ENT organs will be helped by laboratory instrumental research methods:
- the upper part of the chest is examined using radiography, ultrasonography;
- be sure to evaluate the results of general and biochemical blood tests;
- conduct research for sexually transmitted and viral infections;
- ECG and ECHO CG make it possible to distinguish an attack of angina from herpetic inflammation of the stellate ganglion.
Additionally, consultations are carried out with narrow specialists - an otolaryngologist, a dentist, an infectious disease specialist, as well as a dermatologist and ophthalmologist. Only after carefully comparing all the information will a specialist be able to select the optimal treatment regimen for ganglionitis.
Diagnosis of ganglionitis
As a rule, diagnosing the disease is not difficult due to the clear clinical picture.
To make a diagnosis and exclude other causes of pain, a neurologist performs an examination, MRI or CT scan, ultrasonography, radiography, general blood and urine analysis, and ECG.
For reference. Additionally, consultation with an ophthalmologist, dentist, dermatologist, cardiologist, surgeon and infectious disease specialist may be required.
Treatment of ganglionitis
Treatment is divided into etiotropic and symptomatic. Etiotropic therapy is aimed at eliminating the disease that provoked the development of ganglioneuritis. Antiherpetic drugs, antibiotics, antivirals and interferons can be used as etiotropic therapy.
For symptomatic treatment, painkillers, nonsteroidal anti-inflammatory drugs, desensitizing therapy, antispasmodics, nootropics, and vitamin complexes are prescribed.
Additionally, physiotherapy is recommended (diathermotherapy, electrophoresis with drugs, darsonval, UHF).
