Fully endoscopic microvascular decompression for painful tic convulsif secondary to vertebrobasilar dolichoectasia

Vertebrobasilar dolichoectasia is a rare condition that can compress the trigeminal and facial nerves, resulting in trigeminal neuralgia and hemifacial spasms. When these symptoms occur on the same side of the face, the condition is termed painful tic convulsif. Painful tic convulsif secondary to vertebrobasilar dolichoectasia is occasional. This paper presents a case of painful tic convulsif successfully treated by fully endoscopic microvascular decompression. The patient, an older man, experienced paroxysmal pain and involuntary convulsions on the left side of the face for 2 years. Clinical presentation and magnetic resonance imaging results confirmed a painful tic convulsif diagnosis caused by vertebrobasilar dolichoectasia. The patient underwent fully endoscopic microvascular decompression, during which a dilated and tortuous vertebral artery was separated from the affected nerves using a Teflon pad. After surgery, the left-sided facial pain and convulsions were completely relieved without any complications. After 17 months of follow-up, no recurrence was reported. Hence, fully endoscopic microvascular decompression was an effective treatment for painful tic convulsif secondary to vertebrobasilar dolichoectasia.