title: [An unusual presentation of painful tic convulsive].
abstract: BACKGROUND
  The term 'painful tic convulsive' is used to describe the syndrome involving concomitant hemifacial spasm and ipsilateral trigeminal neuralgia. Vascular compression of the fifth and seventh cranial nerves is the most common cause, involving the entry and exit zone of rootlets coming from the brainstem; nevertheless, different etiologies of this syndrome has been previously reported. Treatment for this disease is based on surgical microvascular decompression of the nerve rootlets, but still a topic of debate.
  
  
  METHODS
  A 63-year-old woman with history of 14 years presenting left trigeminal neuralgia, associated with ipsilateral hemifacial spasm for more than ten years. Medical treatment was installed without adequate symptom control. Patient was subjected to surgical treatment via a microasterional approach, with dissection of arachnoid fibrous tissue surrounding fifth and seventh nerves during the first surgery. A second surgery was performed with insertion of a teflon fragment aside of each exit nerve root (V and VII-VIII complex). Symptoms resolved immediately after the surgery and has persisted during the 1-year follow-up. Painful tic convulsive etiology could be multifactorial.
  
  
  CONCLUSIONS
  This report is the first clinical case describing basal arachnoiditis as a primary cause of painful tic convulsive.
authors.affiliation: Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: Romano-Feinholz
authors.affiliation: Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
authors.forename: M P
authors.initials: MP
authors.lastname: Medina
authors.affiliation: Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
authors.forename: F E
authors.initials: FE
authors.lastname: Nares-Lopez
authors.affiliation: Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
authors.forename: J L
authors.initials: JL
authors.lastname: Soto-Hernandez
authors.affiliation: Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico DF, Mexico.
authors.forename: R
authors.initials: R
authors.lastname: Revuelta-Gutierrez
mesh_terms: D001100:Arachnoiditis / Q000150:complications*; D005260:Female; D019569:Hemifacial Spasm / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D014277:Trigeminal Neuralgia / Q000209:etiology*