Microvascular Decompression of Painful tic Convulsif Caused by a Tortous Vertebrobasilar System

ABSTRACT

We report a case of"painful tic convulsif"caused by a tortous vertebrobasilar system, and present the case of a 59-year-old woman with right-sided trigeminal neuralgia and hemifacial spasm. Using a novel sequence, a dilated and severely elongated vertebrobasilar artery was demonstrated by magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA). During microvascular decompression, the findings of MRI were confirmed and decompression with teflon sheets between the nerves and offending arteries was successfully achieved. Postoperatively, the patient was relieved of pain and twitching.