Unilateral trismus caused by vertebrobasilar dolichoectasia

Area of Science:

• Neurology
• Vascular Neurology
• Neuroanatomy

Background:

• Vertebrobasilar dolichoectasia (VD) is a rare condition characterized by abnormal widening and elongation of the vertebrobasilar arteries.
• VD is typically asymptomatic, but can lead to neurological deficits through compression of adjacent neural structures.
• Trismus, or difficulty opening the jaw, is often associated with local oral conditions or neurological coordination issues.

Observation:

• This report details an unusual case of unilateral motor trigeminal nerve involvement presenting as trismus.
• The patient's trismus was attributed to vertebrobasilar dolichoectasia.
• This presentation is uncommon, as VD is generally asymptomatic.

Findings:

• The study proposes that vertebrobasilar dolichoectasia can directly compress the trigeminal motor root.
• This compression may lead to masseter muscle spasm, causing trismus.
• The proposed mechanism is analogous to the pathogenesis of hemifacial spasm.

Implications:

• This case expands the known clinical manifestations of vertebrobasilar dolichoectasia.
• It suggests a novel differential diagnosis for trismus, particularly when other causes are excluded.
• Understanding this mechanism may inform future diagnostic and therapeutic strategies for trigeminal nerve compression syndromes.