title: A painful tic convulsif due to double neurovascular impingement.
abstract: 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.
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Via G. La Loggia, 1, 90129, Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Giglia
authors.forename: M
authors.initials: M
authors.lastname: Romano
authors.forename: P
authors.initials: P
authors.lastname: Paladino
authors.forename: V
authors.initials: V
authors.lastname: Virzì
authors.forename: F
authors.initials: F
authors.lastname: Narese
authors.forename: A
authors.initials: A
authors.lastname: Palermo
authors.forename: B
authors.initials: B
authors.lastname: Fierro
authors.forename: F
authors.initials: F
authors.lastname: Brighina
mesh_terms: D001488:Basilar Artery / Q000473:pathology* / Q000503:physiopathology; D005155:Facial Nerve Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D019569:Hemifacial Spasm / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology