ABSTRACT
Simultaneous hemifacial spasm (HFS) and trigeminal neuralgia caused by cranial nerve (CN) compression from a tortuous basilar artery (BA) is very rare. We report a case of a 66-year-old man who presented with both HFS and "atypical" trigeminal neuralgia. The patient had a tortuous BA compressing both CN V and VII. The patient underwent microvascular decompression after failing conservative medical management. To the best of our knowledge this is the first reported case of both HFS and "atypical" trigeminal neuralgia that were both successfully treated by surgical intervention. We report the management of this rare combination and review the literature.
Subject(s)
Abducens Nerve/surgery , Basilar Artery/surgery , Hemifacial Spasm/surgery , Neuralgia/surgery , Trigeminal Nerve/surgery , Trigeminal Neuralgia/surgery , Aged , Basilar Artery/pathology , Decompression, Surgical , Humans , Male , Microvascular Decompression Surgery , Nerve Compression Syndromes/surgery , Treatment OutcomeABSTRACT
We have identified the first putative integral membrane pentraxin and named it neuronal pentraxin receptor (NPR). NPR is enriched by affinity chromatography on columns of a snake venom toxin, taipoxin, and columns of the taipoxin-binding proteins neuronal pentraxin 1 (NP1), neuronal pentraxin 2 (NP2), and taipoxin-associated calcium-binding protein 49 (TCBP49). The predominant form of NPR contains an putative NH2-terminal transmembrane domain and all forms of NPR are glycosylated. NPR has 49 and 48% amino acid identity to NP1 and NP2, respectively, and NPR message is expressed in neuronal regions that express NP1 and NP2. We suggest that NPR, NP1, NP2, and TCBP49 are involved in a pathway responsible for the transport of taipoxin into synapses and that this may represent a novel neuronal uptake pathway involved in the clearance of synaptic debris.
Subject(s)
C-Reactive Protein/chemistry , C-Reactive Protein/metabolism , Calcium-Binding Proteins/metabolism , Elapid Venoms/metabolism , Membrane Glycoproteins/isolation & purification , Nerve Tissue Proteins/chemistry , Nerve Tissue Proteins/metabolism , Receptors, Cell Surface/isolation & purification , Amino Acid Sequence , Animals , Base Sequence , Chromatography, Affinity , In Situ Hybridization , Mannosyl-Glycoprotein Endo-beta-N-Acetylglucosaminidase/metabolism , Membrane Glycoproteins/genetics , Membrane Glycoproteins/metabolism , Molecular Sequence Data , Molecular Weight , RNA, Messenger/metabolism , Rats , Receptors, Cell Surface/genetics , Receptors, Cell Surface/metabolism , Sequence AlignmentABSTRACT
We have previously identified novel members of the pentraxin family (neuronal pentraxin 1 and 2) that are expressed in the nervous system. Neuronal pentraxin 1 (NP1) was identified as a rat protein that may mediate the uptake of synaptic material and the presynaptic snake venom toxin, taipoxin. NP2 was identified as a separate gene discovered by screening for a human homolog for NP1. Here, we report human cDNA and mouse genomic DNA sequences for NP1 (gene symbol NPTX1). Human NP1 and mouse NP1 show 95 and 99% amino acid identity, respectively, with rat NP1 and conserve all potential glycosylation sites. Like rat NP1, human NP1 message is large (6.5 kb) and is exclusively localized to the nervous system. The mouse NP1 gene is 13 kb in length and contains four introns that break the coding sequence of NP1 in the same positions as the introns of the human NP2 gene. The human and mouse NP1 genes are localized to chromosome 17q25.1-q25.2 and chromosome 11e2-e1.3, respectively. These data demonstrate the existence of a separate family of pentraxin proteins that are expressed in the human brain and other tissues and that may play important roles in the uptake of extracellular material.
