Nota Clínica

An unusual presentation of painful tic convulsive

S. Romano-Feinholz, M.P. Medina, F.E. Nares-López, J.L. Soto-Hernández, R. Revuelta-Gutiérrez [REV NEUROL 2017;64:264-266] PMID: 28272727 DOI: https://doi.org/10.33588/rn.6406.2016434

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Volumen 64 | Number 06 | Nº of views of the article 5.335 | Nº of PDF downloads 115 | Article publication date 16/03/2017

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ABSTRACT

INTRODUCTION The term painful tic convulsive is used to describe the syndrome involving concomitant hemifacial spasm and ipsilateral trigeminal neuralgia. Vascular compression of the fifth and seventh cranial nerves is the most common cause, involving the entry and exit zone of rootlets coming from the brainstem; nevertheless, different etiologies of this syndrome has been previously reported. Treatment for this disease is based on surgical microvascular decompression of the nerve rootlets, but still a topic of debate.

CASE REPORT A 63-year-old woman with history of 14 years presenting left trigeminal neuralgia, associated with ipsilateral hemifacial spasm for more than ten years. Medical treatment was installed without adequate symptom control. Patient was subjected to surgical treatment via a microasterional approach, with dissection of arachnoid fibrous tissue surrounding fifth and seventh nerves during the first surgery. A second surgery was performed with insertion of a teflon fragment aside of each exit nerve root (V and VII-VIII complex). Symptoms resolved immediately after the surgery and has persisted during the 1-year follow-up. Painful tic convulsive etiology could be multifactorial. CONCLUSION. This report is the first clinical case describing basal arachnoiditis as a primary cause of painful tic convulsive. KeywordsArachnoiditis Hemifacial spasm Microasterional approach Microvascular decompression Painful tic convulsive Trigeminal neuralgia CategoriesDolor

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Nota Clínica

An unusual presentation of painful tic convulsive

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