Teaching NeuroImages: Concurrent hemifacial spasm and trigeminal neuralgia due to vertebrobasilar dolichoectasia

Background: Vertebrobasilar dolichoectasia (VBD) is one of the rare causes of trigeminal neuralgia (TN). The common surgical treatments for patients with TN caused by VBD (VBD-TN) are microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically compared, so this study was performed to evaluate the treatment outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study was performed from March 2011 to March 2019 in Wuhan Union Hospital. A total of 80 patients diagnosed with VBD-TN were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. The imaging data, intraoperative findings, treatment outcomes, and complications of the two groups were analyzed and compared. Meanwhile, the influencing factors of the treatment effect are also explored on the two groups.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, respectively, p = 0.03). The median follow-up was 61.1 months for the MVD group and 56.8 months for the GKRS group. The favorable outcomes [Barrow Neurological Institute (BNI) pain score, BNI scores I–II] occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (p = 0.009). The favorable outcomes in the percentage of patients after MVD 1, 3, 5, and 7 years were 95.7, 85.1, 74.2, and 74.2%, respectively, whereas the corresponding percentages after GKRS were 76.5, 66.2, 56.6, and 47.2%, respectively (p = 0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (p = 0.036), but the incidence of new and worsening facial numbness was lower in the GKRS group (p < 0.001).Conclusions: MVD is superior to GKRS in obtaining and maintaining favorable outcomes for patients with VBD-TN, but it also comes with more complications other than facial numbness. Thus, the treatment program can be tailored to a patient's unique condition and wishes.

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Lidocaine Infusion Treatment for Trigeminal Neuralgia Due to Vertebrobasilar Dolichoectasia in a Patient after Right Thyroidectomy

Journal of Anesthesia and Perioperative Medicine ◽

10.24015/japm.2018.0053 ◽

2018 ◽

Vol 5 (6) ◽

pp. 355-358

Author(s):

Tuan Tran ◽

Daryl Smith ◽

Nobuyuki-Hai Tran

Keyword(s):

Trigeminal Neuralgia ◽

Vertebrobasilar Dolichoectasia

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Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

10.21203/rs.3.rs-1064619/v1 ◽

2021 ◽

Author(s):

Tao Sun ◽

Wentao Wang ◽

Longshuang He ◽

Yu Su ◽

Ning Li ◽

...

Keyword(s):

Nervous System ◽

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Treatment Strategies ◽

Glossopharyngeal Neuralgia ◽

Case Presentation ◽

Involuntary Contraction ◽

History Of ◽

Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

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TRIGEMINAL NEURALGIA—HEMIFACIAL SPASM—PAGET'S DISEASE

Brain ◽

10.1093/brain/89.3.555 ◽

1966 ◽

Vol 89 (3) ◽

pp. 555-562 ◽

Cited By ~ 43

Author(s):

W. JAMES GARDNER ◽

DONALD F. DOHN

Keyword(s):

Trigeminal Neuralgia ◽

Hemifacial Spasm ◽

Paget’S Disease ◽

Paget's Disease

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Endoscopic-Assisted Microvascular Decompression

Effective Techniques for Managing Trigeminal Neuralgia - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-5349-6.ch007 ◽

2018 ◽

pp. 139-154

Author(s):

M. Yashar S. Kalani ◽

Michael R. Levitt ◽

Celene B. Mulholland ◽

Charles Teo ◽

Peter Nakaji

Keyword(s):

Trigeminal Neuralgia ◽

Minimally Invasive ◽

Effective Treatment ◽

Hemifacial Spasm ◽

Microvascular Decompression ◽

Patient Population ◽

Surgical Intervention ◽

Cranial Nerves ◽

Vascular Compression ◽

Ephaptic Transmission

Diseases of ephaptic transmission are commonly caused by vascular compression of cranial nerves. The advent of microvascular decompression has allowed for surgical intervention for this patient population. This chapter highlights the technique of endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm. Endoscopy and keyhole techniques have resulted in a minimally invasive and effective treatment of symptoms for patients with neuralgia.

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