Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Shunping County Hospital, Baoding, Hebei Province, China.
World Neurosurg. 2021 Mar;147:e130-e147. doi: 10.1016/j.wneu.2020.11.161. Epub 2020 Dec 8.
Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity that has not yet been systematically studied.
To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC.
We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between establishment of the library and July 1, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first performed descriptive analysis of demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were used to explore potential prognosis predictors. Further, a 2-step meta-analysis method was used to validate the identified factors.
Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of patients with PTC is 54 years (range, 44-62 years), with more patients being female (P < 0.001), initiated as HFS (P = 0.005), and being affected with left side (P = 0.045). The vertebrobasilar artery contributes to >65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement (odds ratio, 4.050; 95% confidence interval, 1.091-15.031) and older age (P = 0.008) predict freedom from symptoms and recurrence after microvascular decompression, respectively.
PTC occurs more in middle-aged women between 40 and 60 years old, initiates as HFS, and affects the left side. Vertebrobasilar artery compression is the most common single cause of PTC. Microvascular decompression effectively treated PTC, with a cure rate >80%. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement predicts successful surgery and older age predicts recurrence.
痛性抽搐（PTC）表现为三叉神经痛和同侧半面痉挛（HFS）共存，是一种罕见的实体，尚未得到系统研究。
系统探讨 PTC 的流行病学、病因、预后及预后预测因素。
我们检索了 PubMed、Web of Science 和 Cochrane 图书馆自建库至 2020 年 7 月 1 日发表的相关研究。提取人口统计学、病因、特定干预措施和干预结果的信息。我们首先对 PTC 的人口统计学、病因和手术结果进行描述性分析。使用单变量和多变量回归方法探讨潜在的预后预测因素。进一步，采用 2 步 meta 分析方法验证鉴定的因素。
总体上，纳入了 57 项报告共 192 例 PTC 患者的分析。PTC 患者的中位年龄为 54 岁（范围 44-62 岁），女性患者更多（P < 0.001），起始表现为 HFS（P = 0.005），左侧受累（P = 0.045）。椎动脉压迫是引起 PTC 单一血管压迫的主要原因（占比＞65%）。小脑前下动脉/小脑后下动脉受累（优势比，4.050；95%置信区间，1.091-15.031）和年龄较大（P = 0.008）分别预测微血管减压术后症状缓解和复发。
PTC 更多发生在 40-60 岁的中年女性，起始表现为 HFS，左侧受累。椎动脉压迫是 PTC 最常见的单一病因。微血管减压术有效地治疗了 PTC，治愈率＞80%。小脑前下动脉/小脑后下动脉受累预测手术成功，年龄较大预测复发。
