Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Division of Neurosurgery, University of British Columbia, Vancouver, Canada.
Neurosurgery. 2020 Oct 15;87(5):E573-E577. doi: 10.1093/neuros/nyz546.
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.
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.
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.
半喉咽肌痉挛（HeLPS）最近才被描述出来，但尚未得到广泛认可。患者描述间歇性咳嗽和窒息，在接受第 X 颅神经微血管减压术后可以治愈。本病例报告和文献复习强调，HeLPS 可与舌咽神经痛（GN）同时发生，并且在神经外科学文献中已有先前描述（但未被认识）。
报告了一例 GN 患者和其他符合 HeLPS 的症状。患者报告左侧间歇性吞咽诱发的剧烈电击样疼痛从耳朵放射到喉咙（GN）。她还报告间歇性剧烈咳嗽、喉咙收缩导致窒息感和发音困难（HeLPS）。所有症状在左侧小脑后下动脉环行减压后缓解，该动脉搏动压迫第 IX 颅神经和第 X 颅神经。回顾高级作者的数据库，发现另一名患者有这种组合症状。国际文献回顾发现，27 名患者以前曾被描述过 GN 的症状以及额外的（但当时未被识别）HeLPS 症状。
本综述强调，自 1926 年以来，至少有 4 种语言报道过符合 HeLPS 症状的患者。这一额外的证据支持了越来越多的人认识到 HeLPS 是另一种神经血管压迫综合征。HeLPS 患者继续被误诊为转换障碍。对这种新的医疗状况的认识增加将需要神经外科治疗，并应减轻这些患者的痛苦。
