Jiang Haotian, Zou Dewei, Shao Chuan, Wu Nan
Department of Neurosurgery, Chongqing General Hospital, Chongqing University No. 118 Xingguang Boulevard, Liangjiang New Area, Chongqing 401147, P. R. China.
Am J Transl Res. 2025 May 15;17(5):3824-3829. doi: 10.62347/URCV2139. eCollection 2025.
Vertebrobasilar dolichoectasia is a rare condition that can compress the trigeminal and facial nerves, resulting in trigeminal neuralgia and hemifacial spasms. When these symptoms occur on the same side of the face, the condition is termed painful tic convulsif. Painful tic convulsif secondary to vertebrobasilar dolichoectasia is occasional. This paper presents a case of painful tic convulsif successfully treated by fully endoscopic microvascular decompression. The patient, an older man, experienced paroxysmal pain and involuntary convulsions on the left side of the face for 2 years. Clinical presentation and magnetic resonance imaging results confirmed a painful tic convulsif diagnosis caused by vertebrobasilar dolichoectasia. The patient underwent fully endoscopic microvascular decompression, during which a dilated and tortuous vertebral artery was separated from the affected nerves using a Teflon pad. After surgery, the left-sided facial pain and convulsions were completely relieved without any complications. After 17 months of follow-up, no recurrence was reported. Hence, fully endoscopic microvascular decompression was an effective treatment for painful tic convulsif secondary to vertebrobasilar dolichoectasia.
椎基底动脉延长扩张症是一种罕见的疾病，可压迫三叉神经和面神经，导致三叉神经痛和半面痉挛。当这些症状出现在面部同一侧时，这种情况被称为痛性抽搐综合征。继发于椎基底动脉延长扩张症的痛性抽搐综合征较为少见。本文介绍了一例通过完全内镜下微血管减压术成功治疗的痛性抽搐综合征病例。该患者为一名老年男性，左侧面部阵发性疼痛和不自主抽搐2年。临床表现和磁共振成像结果证实为椎基底动脉延长扩张症所致的痛性抽搐综合征诊断。患者接受了完全内镜下微血管减压术，术中使用特氟龙垫将扩张迂曲的椎动脉与受累神经分离。术后，左侧面部疼痛和抽搐完全缓解，无任何并发症。随访17个月，无复发报告。因此，完全内镜下微血管减压术是治疗继发于椎基底动脉延长扩张症的痛性抽搐综合征的有效方法。
