title: Neurovascular compression in painful tic convulsif.
abstract: This article describes the case of a 67-year-old woman who presented with a typical left hemifacial spasm of 8-month duration. After 2 months, she experienced lacinating and sharp shock-like pain in the left side of her face affecting the V1 and V2 territories and a discrete attenuation of nauseous reflex on the left side. CT angiography and MRI revealed significant compression of left cranial nerves V, VII, VIII, IX and X by a giant and tortuous vertebro-basilar arterial complex. This case illustrates the nonlinearity of the relationship between the presence of the stressor factor and the actual manifestation of the disease.
authors.affiliation: Division of Functional Neurosurgery, Department of Neurology of School of Medicine of University of São Paulo, São Paulo, SP, Brazil. fonoffet@usp.br
authors.forename: E T
authors.initials: ET
authors.lastname: Fonoff
authors.forename: V P
authors.initials: VP
authors.lastname: Araújo
authors.forename: Y S A
authors.initials: YS
authors.lastname: de Oliveira
authors.forename: M J
authors.initials: MJ
authors.lastname: Teixeira
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D003389:Cranial Nerve Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003391:Cranial Nerves / Q000473:pathology / Q000503:physiopathology; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014276:Trigeminal Nerve / Q000473:pathology / Q000503:physiopathology; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D014711:Vertebral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000473:pathology / Q000503:physiopathology