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RESEARCH PRODUCT
A painful tic convulsif due to double neurovascular impingement
Marcello RomanoAntonio PalermoFilippo BrighinaF. NareseBrigida FierroV. VirzìPiera PaladinoGiuseppe Gigliasubject
Malemedicine.medical_specialtyClinical NeurologyFacial Nerve DiseasesPainful tic convulsifSettore BIO/09 - FisiologiaDouble vascular impingementTrigeminal neuralgiamedicine.arteryVertebrobasilar InsufficiencymedicineBasilar arteryHumansCorneal reflexVertebrobasilar insufficiencybusiness.industryBrief ReportGeneral MedicineMiddle AgedTrigeminal NeuralgiaNeurovascular bundlemedicine.diseaseSurgeryPainful tic convulsif; Trigeminal neuralgia; hemifacial spasm; double vascular impingementTreatment OutcomeAnesthesiology and Pain Medicinemedicine.anatomical_structureHemifacial spasmBasilar ArteryAnesthesiaSettore MED/26 - NeurologiaNeurology (clinical)Facial Nerve DiseasesCerebellar arterybusinessHemifacial spasmdescription
Here we present the case of a 50-year-old man suffering from "painful tic convulsif", on the left side of the face, i.e., left trigeminal neuralgia associated with ipsilateral hemifacial spasm. An angio-MRI scan showed a neurovascular confliction of left superior cerebellar artery with the ipsilateral V cranial nerve and of the left inferior cerebellar artery with the ipsilateral VII cranial nerve. Neurophysiological evaluation through esteroceptive blink reflex showed the involvement of left facial nerve. An initial carbamazepine treatment (800 mg/daily) was completely ineffective, so the patient was shifted to lamotrigine 50 b.i.d. that was able to reduce attacks from 4 to 6 times per day to 1 to 2 per week. Considering the good response to the drug, the neurosurgeon decided to delay surgical treatment.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2011-01-01 | The Journal of Headache and Pain |