Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Via G. La Loggia, 1, 90129, Palermo, Italy.
J Headache Pain. 2011 Dec;12(6):653-6. doi: 10.1007/s10194-011-0370-0. Epub 2011 Aug 4.
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.
在这里，我们报告了一例 50 岁男性患者，患有“疼痛性抽搐”，位于左侧面部，即左侧三叉神经痛伴同侧面肌痉挛。血管 MRI 扫描显示左侧小脑上动脉与同侧 V 颅神经、左侧小脑下前动脉与同侧 VII 颅神经之间存在血管神经冲突。通过体感眨眼反射的神经生理学评估显示左侧面神经受累。初始卡马西平治疗（800mg/天）完全无效，因此患者转为每日两次服用拉莫三嗪 50mg，将每天发作次数从 4 到 6 次减少到每周 1 到 2 次。鉴于药物反应良好，神经外科医生决定推迟手术治疗。
