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[Painful tic convulsif and Botulinum toxin]
M E Boscá-Blasco1, J A Burguera-Hernández, S Roig-Morata
1Servicio de Neurología, Hospital Universitari La Fe, 46009 Valencia, España. bosca_mar@gva.es
Revista De Neurologia
|June 16, 2006
Summary
Botulinum toxin effectively treated painful tic convulsif, a rare disorder combining trigeminal neuralgia (TN) and hemifacial spasm (HFS). This suggests a shared cause and a central mechanism of action for the toxin in managing these hyperactive cranial nerve conditions.
Area of Science:
- Neurology
- Neurosurgery
- Pharmacology
Background:
- Painful tic convulsif, characterized by trigeminal neuralgia (TN) and ipsilateral hemifacial spasm (HFS), is a rare disorder.
- Both TN and HFS are common examples of hyperactive cranial rhizopathy.
- Vascular compression of cranial nerves at the brain stem's nerve root entry/exit zone often causes these conditions, leading to ephaptic transmission.
Observation:
- This study reports on four patients with combined TN and HFS treated with botulinum toxin.
- Three patients had ipsilateral TN and HFS, with one experiencing bilateral HFS.
- One patient presented with contralateral TN to the HFS.
Findings:
- All four patients showed improvement in both HFS and TN following botulinum toxin treatment.
- The study suggests a common etiology for TN and HFS, possibly central neuronal hyperactivity or multi-cranial nerve compression.
- Botulinum toxin's efficacy in both conditions supports a central mechanism of action, potentially modulating brainstem neuronal hyperactivity.
Implications:
- Botulinum toxin may offer a therapeutic option for patients with combined TN and HFS.
- Further research into the central effects of botulinum toxin for neurological disorders is warranted.
- Understanding the shared etiology of TN and HFS could lead to more targeted treatments.