title: [Painful tic convulsif: Case series and literature review].
abstract: BACKGROUND
  The coexistence of hemifacial spasm and trigeminal neuralgia, a clinical entity known as painful tic convulsive, was first described in 1910. It is an uncommon condition that is worthy of interest in neurosurgical practice, because of its common pathophysiology mechanism: Neuro-vascular compression in most of the cases.
  
  
  OBJECTIVE
  To present 2 cases of painful tic convulsive that received treatment at our institution, and to give a brief review of the existing literature related to this. The benefits of micro-surgical decompression and the most common medical therapy used (botulin toxin) are also presented.
  
  
  METHODS
  Two cases of typical painful tic convulsive are described, showing representative slices of magnetic resonance imaging corresponding to the aetiology of each case, as well as a description of the surgical technique employed in our institution. The immediate relief of symptomatology, and the clinical condition at one-year follow-up in each case is described. A brief review of the literature on this condition is presented.
  
  
  CONCLUSIONS
  This very rare neurological entity represents less than 1% of rhizopathies and in a large proportion of cases it is caused by vascular compression, attributed to an aberrant dolichoectatic course of the vertebro-basilar complex. The standard modality of treatment is micro-vascular surgical decompression, which has shown greater effectiveness and control of symptoms in the long-term. However medical treatment, which includes percutaneous infiltration of botulinum toxin, has produced similar results at medium-term in the control of each individual clinical manifestation, but it must be considered as an alternative in the choice of treatment.
authors.affiliation: Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Ciudad de México, México.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Revuelta-Gutiérrez
authors.affiliation: Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Ciudad de México, México. Electronic address: hsvtorres@gmail.com.
authors.forename: Héctor Sebastián
authors.initials: HS
authors.lastname: Velasco-Torres
authors.affiliation: Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Ciudad de México, México.
authors.forename: Lourdes Olivia
authors.initials: LO
authors.lastname: Vales Hidalgo
authors.affiliation: Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Ciudad de México, México.
authors.forename: Jaime Jesús
authors.initials: JJ
authors.lastname: Martínez-Anda
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
chemical_list: D019274:Botulinum Toxins, Type A
keywords: Botulin toxin; Compresión neurovascular; Dolichoectasia; Dolicoectasia; Espasmo hemifacial; Hemifacial spasm; Neuralgia del trigémino; Neuro-vascular compression; Painful tic convulsive; Tic convulsivo doloroso; Toxina botulínica; Trigeminal neuralgia