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Painful tic convulsif: case report.

M Tsuyumu1, Y Kohmo

  • 1Department of Neurosurgery, Yokosuka National Hospital, Japan.

Surgical Neurology
|October 1, 1991
PubMed
Summary

A case of painful tic convulsif, trigeminal neuralgia, and facial spasm in a 77-year-old woman was treated by relieving arterial compression of cranial nerves. The patient experienced significant pain relief and spasm reduction post-surgery.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Vascular Neurology

Background:

  • Trigeminal neuralgia (TN) and facial spasms (FS) can significantly impact quality of life.
  • Vascular compression of cranial nerves is a known, yet complex, etiology for these conditions.
  • Understanding the specific neurovascular relationships is crucial for effective surgical intervention.

Observation:

  • A 77-year-old female presented with a 12-year history of trigeminal neuralgia and a 2-year history of ipsilateral facial spasm.
  • Intraoperative findings revealed the superior cerebellar artery impinging on the trigeminal nerve (CN V) entry zone.
  • Additionally, the anterior inferior and posterior inferior cerebellar arteries were observed to be compressing the facial nerve (CN VII).

Findings:

  • Surgical decompression using Teflon sheets successfully separated the offending arteries from the cranial nerves.
  • The patient remained pain-free and spasm-free for at least 18 months post-operatively, indicating successful treatment.
  • This case highlights the potential for multiple cranial nerve compression syndromes to coexist.

Implications:

  • Microvascular decompression is an effective treatment for complex cases of trigeminal neuralgia and facial spasm.
  • Accurate identification of causative vascular structures is paramount for successful surgical outcomes.
  • Further research into the pathomechanisms of associated neurovascular compression syndromes is warranted.

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