Cerebellopontine angle epidermoid tumor presenting with 'tic convulsif' and tinnitus--case report

A 22-year-old female presented with a cerebellopontine angle epidermoid tumor manifesting as a rare combination of hemifacial spasm, trigeminal neuralgia, and tinnitus. Magnetic resonance imaging demonstrated the tumor distorting the brainstem and the fourth ventricle. The tumor was almost completely resected and the seventh-eighth cranial nerve complex was decompressed by mobilizing the anterior inferior cerebellar artery loop. No arterial loop was related to the trigeminal nerve. The patient was completely relieved of the "tic convulsif" and tinnitus after the surgery. The inflammatory nature of epidermoid tumor may be involved in the etiology of the syndrome. Microvascular decompression may be needed in addition to tumor removal in such cases.