Successful Microvascular Decompression of Spasmodic Torticollis with Multiple Vascular Compression on the Course of the 11th Nerve : A Case Report

Abstract Background Primary facial spasm accompanied by arrhythmia is a rare clinical phenomenon and has not been reported before. We describe this phenomenon and discuss its mechanism and treatment. Case presentation We herein present a rare case of a patient with left primary facial spasm and a third-degree atrioventricular block (III degree AVB), who was implanted with a temporary cardiac pacemaker to receive microvascular decompression (MVD) because of refusal of a permanent cardiac pacemaker. The symptoms of facial spasm disappeared after MVD. The temporary cardiac pacemaker was removed on the second day after surgery. Her ECG still showed the third-degree atrioventricular block after a follow-up period of 5 months. Conclusions We are the first to report a patient with facial spasm and arrhythmia who was implanted with a temporary cardiac pacemaker to receive MVD. This case report demonstrated that the concomitant presence of a III degree AVB maybe not a contraindication for MVD, and the etiology of this facial spasm was the actual vascular compression of the facial nerve entry zone that was not related to the atrioventricular block.

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Preoperative MRI characteristics and short-term postoperative outcomes of microvascular decompression in trigeminal neuralgia with no vascular compression

Minerva Anestesiologica ◽

10.23736/s0375-9393.19.14099-0 ◽

2020 ◽

Vol 86 (3) ◽

Author(s):

Zitang Ma ◽

Yong Zhang ◽

Leilei Yu ◽

Hui Zhang ◽

Xiuzhen Zhao ◽

...

Keyword(s):

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Postoperative Outcomes ◽

Vascular Compression ◽

Short Term ◽

Mri Characteristics

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Endoscopic-assisted microvascular decompression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.105749 ◽

2021 ◽

pp. 105749

Author(s):

Ha Dai Duong ◽

Anh Hoang Pham ◽

Tam Duc Le ◽

Hung Thanh Chu ◽

Dung Tuan Pham ◽

...

Keyword(s):

Case Report ◽

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Vertebrobasilar Dolichoectasia

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Welling-up of cerebrospinal fluid is a sign of remote supratentorial hemorrhage during microvascular decompression: a case report

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-020-00079-6 ◽

2020 ◽

Vol 35 (1) ◽

Author(s):

Maidinamu Yakufujiang ◽

Yoshinori Higuchi ◽

Shogo Wakita ◽

Kentaro Horiguchi ◽

Shiro Ikegami ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Microvascular Decompression

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Concurrent Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm (HeLPS): A Case Report and a Review of the Literature

Neurosurgery ◽

10.1093/neuros/nyz546 ◽

2019 ◽

Vol 87 (5) ◽

pp. E573-E577

Author(s):

C Michael Honey ◽

Marie T Krüger ◽

Alan R Rheaume ◽

Josue M Avecillas-Chasin ◽

Murray D Morrison ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Microvascular Decompression ◽

Medical Condition ◽

Posterior Inferior Cerebellar Artery ◽

Cranial Nerves ◽

Conversion Disorder ◽

Glossopharyngeal Neuralgia ◽

Neurovascular Compression ◽

Patient Reported

Abstract BACKGROUND AND IMPORTANCE Hemi-laryngopharyngeal spasm (HeLPS) has been recently described but is not yet widely recognized. Patients describe intermittent coughing and choking and can be cured following microvascular decompression of their Xth cranial nerve. This case report and literature review highlight that HeLPS can co-occur with glossopharyngeal neuralgia (GN) and has been previously described (but not recognized) in the neurosurgical literature. CLINICAL PRESENTATION A patient with GN and additional symptoms compatible with HeLPS is presented. The patient reported left-sided, intermittent, swallow-induced, severe electrical pain radiating from her ear to her throat (GN). She also reported intermittent severe coughing, throat contractions causing a sense of suffocation, and dysphonia (HeLPS). All her symptoms resolved following a left microvascular decompression of a loop of the posterior inferior cerebellar artery that was pulsating against both the IXth and Xth cranial nerves. A review of the senior author's database revealed another patient with this combination of symptoms. An international literature review found 27 patients have been previously described with symptoms of GN and the additional (but not recognized at the time) symptoms of HeLPS. CONCLUSION This review highlights that patients with symptoms compatible with HeLPS have been reported since 1926 in at least 4 languages. This additional evidence supports the growing recognition that HeLPS is another neurovascular compression syndrome. Patients with HeLPS continue to be misdiagnosed as conversion disorder. The increased recognition of this new medical condition will require neurosurgical treatment and should alleviate the suffering of these patients.

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Evaluating Transient Hemifacial Spasm that Reappears After Microvascular Decompression Specifically Focusing on the Real Culprit Location of Vascular Compression

World Neurosurgery ◽

10.1016/j.wneu.2016.10.142 ◽

2017 ◽

Vol 98 ◽

pp. 774-779 ◽

Cited By ~ 3

Author(s):

Hee Sup Shin ◽

Seung Hwan Lee ◽

Hak Cheol Ko ◽

Jun Seok Koh

Keyword(s):

Hemifacial Spasm ◽

Microvascular Decompression ◽

Vascular Compression ◽

The Real

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Positive Effects of Local Anesthetic Nerve Blocks for a Patient with Newly Developed Left Side Spasmodic Torticollis after Surgical Intervention of Right Side Spasmodic Torticollis - A case report -

The Korean Journal of Pain ◽

10.3344/kjp.2007.20.2.246 ◽

2007 ◽

Vol 20 (2) ◽

pp. 246 ◽

Cited By ~ 1

Author(s):

Chang Hoon Choi ◽

Jin Hwan Choi ◽

Choon Ho Sung

Keyword(s):

Case Report ◽

Local Anesthetic ◽

Surgical Intervention ◽

Spasmodic Torticollis ◽

Nerve Blocks ◽

Positive Effects

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Comparison of Clinical Symptoms and Magnetic Resonance Angiographic (MRA) Results in Patients with Trigeminal Neuralgia and Persistent Idiopathic Facial Pain. Medium-Term Outcome after Microvascular Decompression of Cases with Positive MRA Findings

Cephalalgia ◽

10.1111/j.1468-2982.2005.01030.x ◽

2006 ◽

Vol 26 (3) ◽

pp. 266-276 ◽

Cited By ~ 41

Author(s):

A Kuncz ◽

E Vörös ◽

P Barzó ◽

J Tajti ◽

P Milassin ◽

...

Keyword(s):

Magnetic Resonance ◽

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Facial Pain ◽

Clinical Symptoms ◽

Vascular Compression ◽

Term Outcome ◽

Persistent Idiopathic Facial Pain ◽

Venous Compression ◽

Imaging Results

To evaluate whether NC could be demonstrated preoperatively, high-resolution magnetic resonance angiography (MRA) was performed in 287 consecutive patients with TN and persistent idiopathic facial pain (PIFP) on a 0.5-T and a 1-T MR unit. Depending on the clinical symptoms, the TN cases were divided into typical TN and trigeminal neuralgia with non-neuralgic interparoxysmal pain (TNWIP) groups. Microvascular decompression (MVD) was performed in 103 of the MRA-positive cases. The patients were followed up postoperatively for from 1 to 10 years. The clinical symptoms were compared with the imaging results. The value of MRA was assessed on the basis of the clinical symptoms and surgical findings. The outcome of MVD was graded as excellent, good or poor. The clinical symptoms were compared with the type of vascular compression and the outcome of MVD. The MRA image was positive in 161 (56%) of the 287 cases. There were significant differences between the clinical groups: 66.5% of the typical TN group, 47.5% of the TNWIP group and 3.4% of the PIFP group were positive. The quality of the MR unit significantly determined the ratio of positive/negative MRA results. The surgical findings corresponded with the MRA images. Six patients from the MRA-negative group were operated on for selective rhizotomy and no NC was found. Venous compression of the trigeminal nerve was observed in a significantly higher proportion in the background of TNWIP than in that of typical TN on MRA imaging (24.1% and 0.8%, respectively) and also during MVD (31.2% and 1.2%, respectively). Four years following the MVD, 69% of the patients gave an excellent, 23% a good and 8% a poor result. The rate of some kind of recurrence of pain was 20% in the typical TN and 44% in TNWIP group. The rate of recurrence was 57% when pure venous compression was present. The only patient who was operated on from the PIFP group did not react to the MVD. The clinical symptoms and preoperative MRA performed by at least a 1-T MR unit furnish considerable information, which can play a role in the planning of the treatment of TN.

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