Hemifacial spasm associated with trigeminal neuralgia secondary to trigeminal vascular compression.

Autor: Ardisana EF; Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina. Electronic address: ernestofas2018@gmail.com., Villalonga JF; Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina., Suárez MM; Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina., Campero A; Laboratorio de Innovaciones Neuroquirúrgicas de Tucumán (LINT), Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina; Hospital General Angel C. Padilla, Tucumán, Argentina.
Jazyk: angličtina
Zdroj: Neurocirugia (English Edition) [Neurocirugia (Astur : Engl Ed)] 2024 Jul 27. Date of Electronic Publication: 2024 Jul 27.
DOI: 10.1016/j.neucie.2024.07.004
Abstrakt: The coincidence in a patient of Hemifacial Spasm and Trigeminal Neuralgia is not frequent. A case is presented with the objective of showing this association due to the abnormal activation of the Trigemino-Facial Reflex. A 55-year-old woman with an 8-year history of left-sided hemifacial spasm and typical trigeminal pain in the ipsilateral V1 and V2 territory. The physical examination shows spasms in the left hemiface, with reproduction of intense pain upon sensory stimulation of the skin on the forehead and upper dental arch. The MRI showed a vessel in intimate contact with the entrance area of ​​the left trigeminal nerve. A left retrosigmoid approach was performed. First, the entrance area of ​​the trigeminal nerve was accessed, finding a clear vascular conflict, which was isolated with Teflon. Then, the trajectory was changed and the exit zone of the facial nerve was accessed, and no type of vascular conflict was identified. The patient presented complete resolution of the Hemifacial Spasm and the associated trigeminal pain. The analysis of this case allows us to conclude that during microvascular decompression of the Facial Nerve, if frank proximal compression is not evident, the Trigeminofacial structural relationship must be taken into account, making it necessary to explore the Trigeminal Nerve.
(Copyright © 2024. Published by Elsevier España, S.L.U.)
Databáze: MEDLINE
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