Painful Tic Convulsif Research Articles

Risk of Bone Wax Migration During Retrosigmoid Craniotomy for Microvascular Decompression: Case-Control Study.

Bone wax is a flexible hemostatic agent commonly used for surgery in the posterior cranial fossa to control bleeding from the mastoid emissary vein. A large amount of bone wax can migrate into the sigmoid sinus through the mastoid emissary canal (MEC). We aimed to identify clinical factors related to intraoperative bone wax migration through the MEC during microvascular decompression (MVD) surgery, which may result in sigmoid sinus thrombosis. We retrospectively collected the clinical data of patients with trigeminal neuralgia, hemifacial spasm, or trigeminal neuralgia accompanied by painful tic convulsif who underwent MVD. Basic information and the residual width and length (from the bone surface to the sigmoid sinus) of the MEC on computed tomography images were collected. We compared the collected clinical data between 2 groups of cases with and without intraoperative bone wax migration in the sigmoid sinus. Fifty-four cases with intraoperative bone wax migration and 187 patients without migration were enrolled. The t -test revealed significant differences in the width and length of the MEC ( P = .013 and P = .003, respectively). These variables were identified as significant factors in predicting intraoperative bone wax migration using multivariate logistic regression analysis. The large size of the MEC may be related to intraoperative bone wax migration into the sigmoid sinus in MVD. Neurosurgeons should be aware of these risks. Bone wax should be applied appropriately and hemostasis should be considered to control bleeding from the mastoid emissary vein in patients with a large MEC.

Extracranial Radiofrequency Treatment for Painful Tic Convulsif Syndrome Under Local Anesthesia.

IntroductionPainful tic convulsif syndrome is ipsilateral facial trigeminal neuralgia combined with hemifacial spasm, which is relatively rare in the clinic. Microvascular decompression is currently considered to be an effective treatment. We report extracranial radiofrequency treatment of painful tic convulsif syndrome under local anesthesia, a technique which provides a safer and more economical treatment for this kind of patient.Case PresentationWe report a case of painful tic convulsif syndrome which was treated with extracranial radiofrequency therapy of the trigeminal nerve and facial nerve. After operations, the symptoms of pain and spasm were relieved immediately, but the right facial numbness and facial paralysis (House–Brackmann grade III) were left. The facial paralysis was completely relieved after 3 months of follow-up, and there was no recurrence of trigeminal neuralgia or hemifacial spasm after 35 months.DiscussionPainful tic convulsif syndrome is a combination of ipsilateral facial trigeminal neuralgia and hemifacial spasm, which is relatively rare in the clinic. So far, only one treatment method of microvascular decompression has been reported for the disease. We report the first case of CT-guided extracranial radiofrequency therapy for painful tic convulsif syndrome.ConclusionExtracranial radiofrequency therapy can provide safe and economical treatment for patients with painful tic convulsif syndrome.

The Epidemiology, Cause, and Prognosis of Painful Tic Convulsif Syndrome: An Individual Patient Data Analysis of 192 Cases

Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity that has not yet been systematically studied. To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC. We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between establishment of the library and July 1, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first performed descriptive analysis of demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were used to explore potential prognosis predictors. Further, a 2-step meta-analysis method was used to validate the identified factors. Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of patients with PTC is 54 years (range, 44-62 years), with more patients being female (P < 0.001), initiated as HFS (P= 0.005), and being affected with left side (P= 0.045). The vertebrobasilar artery contributes to >65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement (odds ratio, 4.050; 95% confidence interval, 1.091-15.031) and older age (P= 0.008) predict freedom from symptoms and recurrence after microvascular decompression, respectively. PTC occurs more in middle-aged women between 40 and 60 years old, initiates as HFS, and affects the left side. Vertebrobasilar artery compression is the most common single cause of PTC. Microvascular decompression effectively treated PTC, with a cure rate >80%. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement predicts successful surgery and older age predicts recurrence.

Trigeminal neuralgia plus hemifacial spasm caused by a dilated artery: a case of painful tic convulsif syndrome

Trigeminal neuralgia plus hemifacial spasm caused by a dilated artery: a case of painful tic convulsif syndrome

Painful tic convulsif caused by posterior fossa arteriovenous malformation

Episodes of hemifacial spasm (HFS) along with ipsilateral trigeminal neuralgia (TN) is known as painful tic convulsif (PTC). Neurovascular conflict due to vascular compression of involved cranial nerve roots is the most commonly reported pathology resulting in PTC, with ectatic course of vertebrobasilar artery being the most frequent cause. HFS and TN commonly occur in elderly population and atypical causes such as arteriovenous malformation (AVM) may likely affect young patients. To date only three cases of PTC resulting from AVM have been reported. We report a young male presenting with PTC resulting from posterior fossa AVM.

Bilateral painful tic convulsif

‘Painful tic convulsif’ (PTC) describes the coexistence of hemifacial spasm and trigeminal neuralgia. In this report, we describe a unique presentation of bilateral PTC in a man with bilateral hemifacial...

Painful tic convulsif: Case series and literature review

Abstract Background The coexistence of hemifacial spasm and trigeminal neuralgia, a clinical entity known as painful tic convulsive, was first described in 1910. It is an uncommon condition that is worthy of interest in neurosurgical practice, because of its common pathophysiology mechanism: Neuro-vascular compression in most of the cases. Objective To present 2 cases of painful tic convulsive that received treatment at our institution, and to give a brief review of the existing literature related to this. The benefits of micro-surgical decompression and the most common medical therapy used (botulin toxin) are also presented. Clinical cases Two cases of typical painful tic convulsive are described, showing representative slices of magnetic resonance imaging corresponding to the aetiology of each case, as well as a description of the surgical technique employed in our institution. The immediate relief of symptomatology, and the clinical condition at one-year follow-up in each case is described. A brief review of the literature on this condition is presented. Conclusion This very rare neurological entity represents less than 1% of rhizopathies and in a large proportion of cases it is caused by vascular compression, attributed to an aberrant dolichoectatic course of the vertebro-basilar complex. The standard modality of treatment is micro-vascular surgical decompression, which has shown greater effectiveness and control of symptoms in the long-term. However medical treatment, which includes percutaneous infiltration of botulinum toxin, has produced similar results at medium-term in the control of each individual clinical manifestation, but it must be considered as an alternative in the choice of treatment.

Trigeminal neuralgia and hemifacial spasm associated with vertebrobasilar artery tortuosity

The tortuous vertebrobasilar artery (TVBA) often causes neurovascular conflicts in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS). Implementation of microvascular decompression (MVD) in these circumstances is hindered due to stiffness of the enlarged and dilated arteries and is often accompanied by poor outcomes. The surgical strategy in cases of trigeminal neuralgia and hemifacial spasm associated with the TVBA should be clarified in order to achieve good outcomes. MVD was performed in 268 TN patients and 71 HFS patients. The TVBA as a compressing vessel was identified in 30 cases (11 cases of TN, 18 cases of HFS, and 1 patient with painful tic convulsif). All patients underwent MVD and a retrospective analysis of clinical outcomes. Compression caused by the vertebral artery was found in all HFS patients and 4 TN patients, and compression caused by the basilar artery was observed in 7 TN cases. Additional compression of the cranial nerve root entry/exit zone by cerebellar vessels was observed in 21 cases. The TVBA was mobilized by dissection of arachnoid adhesions between the vessel and the brainstem and retracted laterally. Then, the TVBA was retracted from the brainstem to the caudorostral direction. These manipulations resulted is "spontaneous" decompression of the cranial nerves without placing prostheses between the artery and the nerve root entry/exit zone. In all cases (except two), the displaced TVBA was fixed between the enlarged artery and brainstem using pieces of the patient's muscle and adipose tissues, followed by application of fibrin glue. A cylindrical silicone prosthesis was used in 1 case. In another case, the TVBA was retracted using a fascial loop fixed to the dura mater of the petrous pyramid by means of a suture. After application of MVD, TN and HFS symptoms completely regressed. There were several transient complications and 2 cases of permanent hearing loss. No clinical symptom recurrence was observed. MVD is the most effective surgical treatment of TN and HFS caused by the TVBA. The TVBA should be retracted from the brainstem without placing prostheses in the nerve root entry/exit zone.

Rare case of cerebello-pontine angle meningioma causing painful tic convulsif

Hemifacial spasm is commonly causedby the compressive effect f vascular structures on the REZ (root entry zone) of the facial (VII) erve [1]. However, spasm caused by tumor or other intracranial pace occupying lesions in the cerebellopontine angle is rare and nly few cases have been documented in the literature so far [2]. urther, though lesions of the Cerebellopontine angle are known to ause trigeminal neuralgia [3], however, such tumors causing both emifacial spasm and trigeminal neuralgia (painful tic convulsif) re very rare [5]. Here, we report a case of cerebello-pontine angle eningioma with an unusual presentation of painful tic convulsif nd also review the relevant literature.

Microvascular Decompression for the Patient with Painful Tic Convulsif After Bell Palsy

Painful tic convulsif is referred to as the concurrent trigeminal neuralgia and hemifacial spasm. However, painful tic convulsif after ipsilateral Bell palsy has never been reported before. We report a case of a 77-year-old woman with coexistent trigeminal neuralgia and hemifacial spasm who had experienced Bell palsy half a year ago. The patient underwent microvascular decompression. Intraoperatively, the vertebrobasilar artery was found to deviate to the symptomatic side and a severe adhesion was observed in the cerebellopontine angle. Meanwhile, an ectatic anterior inferior cerebellar artery and 2 branches of the superior cerebellar artery were identified to compress the caudal root entry zone (REZ) of the VII nerve and the rostroventral cisternal portion of the V nerve, respectively. Postoperatively, the symptoms of spasm ceased immediately and the pain disappeared within 3 months. In this article, the pathogenesis of the patient's illness was discussed and it was assumed that the adhesions developed from inflammatory reactions after Bell palsy and the anatomic features of the patient were the factors that generated the disorder. Microvascular decompression surgery is the suggested treatment of the disease, and the dissection should be started from the caudal cranial nerves while performing the operation.

Painful Tic Convulsif Caused by an Arteriovenous Malformation

Painful tic convulsif (PTC) is a term to describe the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm, and about four dozen cases have been reported in the literature. With respect to PTC caused by an arteriovenous malformation (AVM), to our knowledge, only two cases have been documented and their angiographic findings were not described. We present here the rare case of PTC attributed to an AVM in the cerebellopontine angle (CPA) and review the relevant literature.

Cranial polyneuropathy associated with vertebrobasilar dolichoectasia

Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity that has not yet been systematically studied.To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC.We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between establishment of the library and July 1, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first performed descriptive analysis of demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were used to explore potential prognosis predictors. Further, a 2-step meta-analysis method was used to validate the identified factors.Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of patients with PTC is 54 years (range, 44–62 years), with more patients being female (P < 0.001), initiated as HFS (P = 0.005), and being affected with left side (P = 0.045). The vertebrobasilar artery contributes to >65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement (odds ratio, 4.050; 95% confidence interval, 1.091–15.031) and older age (P = 0.008) predict freedom from symptoms and recurrence after microvascular decompression, respectively.PTC occurs more in middle-aged women between 40 and 60 years old, initiates as HFS, and affects the left side. Vertebrobasilar artery compression is the most common single cause of PTC. Microvascular decompression effectively treated PTC, with a cure rate >80%. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement predicts successful surgery and older age predicts recurrence.

Arachnoid cyst associated with painful tic convulsif

Combined clinical presentation of hemifacial spasm and ipsilateral trigeminal neuralgia is known as painful tic convulsif (PTC). It is a rare condition and the most common cause is vascular compression. We report an arachnoid cyst of the posterior fossa that caused PTC in a 50-year-old woman. Her radiological evaluation revealed a median, well-circumscribed, cystic lesion of the posterior fossa suggestive of arachnoid cyst, pushing the cerebellum and brainstem anteriorly. Midline suboccipital craniotomy and marsupialization of cyst was performed with complete recovery of symptoms. To our knowledge, this is the first report of a retrocerebellar arachnoid cyst causing PTC.

Painful tic convulsif syndrome due to vertebrobasilar dolichoectasia

Combined clinical presentation of hemifacial spasm and ipsilateral trigeminal neuralgia is also known as painful tic convulsif (PTC). It is a rare condition and the most common cause is vascular compression. Vertebrobasilar dolichoectasia (VBD) is characterized by dilated and tortuous vertebral and basilar arteries. VBD is an uncommon and rarely reported cause of PTC. Magnetic resonance imaging (MRI), due to its inherent excellent contrast resolution, is an excellent modality for demonstrating the nerve compression by dilated and tortuous vessels seen in this condition. For this purpose, 3D MRI sequences are especially useful like constructive interference in steady state (CISS) and MR angiography. Both of these have been reported to be helpful in the diagnosis of this condition. We report a case of PTC in which we were able to document facial and trigeminal nerve compression by VBD on MRI, using CISS and time-of-flight MR angiography.

Simultaneous involvement of fifth and seventh nerves by vertebrobasilar dolichoectasia presenting as painful tic convulsif - Demonstrated by MR imaging

Simultaneous involvement of fifth and seventh nerves by vertebrobasilar dolichoectasia presenting as painful tic convulsif - Demonstrated by MR imaging

UNUSUAL CAUSES AND PRESENTATIONS OF HEMIFACIAL SPASM

To evaluate unusual possible causes and clinical presentations of hemifacial spasm (HFS). The authors reviewed 1642 cases of HFS. Assessments were based on clinical features, 3-dimensional time-of-flight magnetic resonance angiography, and surgical findings. Causes other than neurovascular compression at the root exit zone of the facial nerve were investigated and unusual clinical presentations were noted. Nine (0.5%) patients had a secondary causative structural lesion, 7 patients had a tumor, and the remaining 2 had a vascular malformation. Direct compression by dolichoectatic vertebrobasilar artery was noted in 12 (0.7%) patients. In 7 (0.4%) patients, only the distal portion of the facial nerve was compressed, and five (0.3%) had only venous compression. Bilateral HFS and tic convulsif were encountered in 7 (0.4%) and 6 (0.37%) patients, respectively. Fifty-six (3.4%) patients were younger than 30 years old at the time of microvascular decompression. HFS can result from tumor, vascular malformation, and dolichoectatic artery. Therefore, appropriate preoperative radiological investigations are crucial to achieve a correct diagnosis. The authors emphasize that distal compression or only venous compression can be responsible for persistent or recurrent symptoms postoperatively. In cases of bilateral HFS, a definite differential diagnosis is necessary for appropriate therapy. MVD is recommended as the treatment of choice in patients younger than 30 years old or patients with painful tic convulsif.

Neurovascular compression in painful tic convulsif

This article describes the case of a 67-year-old woman who presented with a typical left hemifacial spasm of 8-month duration. After 2 months, she experienced lacinating and sharp shock-like pain in the left side of her face affecting the V1 and V2 territories and a discrete attenuation of nauseous reflex on the left side. CT angiography and MRI revealed significant compression of left cranial nerves V, VII, VIII, IX and X by a giant and tortuous vertebro-basilar arterial complex. This case illustrates the nonlinearity of the relationship between the presence of the stressor factor and the actual manifestation of the disease.

Bilateral hemifacial spasm and trigeminal neuralgia: A unique form of painful tic convulsif

Bilateral hemifacial spasm and trigeminal neuralgia: A unique form of painful tic convulsif

Tic convulsivo doloroso y toxina botulínica

Painful tic convulsif is a rare disorder that associates trigeminal neuralgia (TN) and ipsilateral hemifacial spasm (HFS). These two disorders are the most common examples of hyperactive cranial rhizopathy and are frequently caused by vascular compression of these cranial nerves at the nerve root entry and exit zone in the brain stem, which leads to paroxysmal ephaptic transmission.We report the cases of four patients with combined TN and HFS out of a total of 247 patients with HFS who were treated with botulinum toxin. One patient had TN that was contralateral to the HFS, while the other three were ipsilateral, and one of these had bilateral HFS. In all four cases both the HFS and the TN improved with botulinum toxin treatment.These four patients with TN and HFS suggest a common aetiology for the two disorders, due either to central neuronal hyperactivity or to vascular compression of several cranial nerves. The beneficial effect of botulinum toxin in both disorders supports the idea of this toxin having a central mechanism of action that acts by controlling neuronal hyperactivity in the brain stem, as well as its peripheral action.

Tic convulsif caused by cerebellopontine angle schwannoma

A case is presented of painful tic convulsif caused by schwannoma in the cerebellopontine angle (CPA), with right trigeminal neuralgia and ipsilateral hemifacial spasm. Magnetic resonance images showed a 4 cm round mass displacing the 4th ventricle and distorting the brain stem in the right CPA. The schwannoma, which compressed the fifth and seventh cranial nerves directly, was subtotally removed by a suboccipital craniectomy. Postoperatively, the patient had a complete relief from the hemifacial spasm and marked improvement from trigeminal neuralgia. The painful tic convulsif in this case was probably produced by the tumor compressing and displacing the anterior cerebellar artery directly.