The Epidemiology, Cause, and Prognosis of Painful Tic Convulsif Syndrome: An Individual Patient Data Analysis of 192 Cases

Zixiao Yin; Yuye Liu; Yutong Bai; Hua Zhang; Wei Yao; Feng Yu; Jianguo Zhang; Ruen Liu; Anchao Yang

doi:10.1016/j.wneu.2020.11.161

The Epidemiology, Cause, and Prognosis of Painful Tic Convulsif Syndrome: An Individual Patient Data Analysis of 192 Cases

World Neurosurg. 2021 Mar:147:e130-e147. doi: 10.1016/j.wneu.2020.11.161. Epub 2020 Dec 8.

Authors

Zixiao Yin¹, Yuye Liu¹, Yutong Bai¹, Hua Zhang¹, Wei Yao², Feng Yu³, Jianguo Zhang⁴, Ruen Liu⁵, Anchao Yang⁶

Affiliations

¹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Shunping County Hospital, Baoding, Hebei Province, China.
³ Department of Neurosurgery, PLA 960th Hospital, Jinan, Shandong Province, China.
⁴ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
⁵ Peking University People's Hospital, Beijing, China.
⁶ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: yang.anchao@163.com.

PMID: 33307261
DOI: 10.1016/j.wneu.2020.11.161

Abstract

Background: Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity that has not yet been systematically studied.

Objective: To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC.

Methods: We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between establishment of the library and July 1, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first performed descriptive analysis of demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were used to explore potential prognosis predictors. Further, a 2-step meta-analysis method was used to validate the identified factors.

Results: Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of patients with PTC is 54 years (range, 44-62 years), with more patients being female (P < 0.001), initiated as HFS (P = 0.005), and being affected with left side (P = 0.045). The vertebrobasilar artery contributes to >65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement (odds ratio, 4.050; 95% confidence interval, 1.091-15.031) and older age (P = 0.008) predict freedom from symptoms and recurrence after microvascular decompression, respectively.

Conclusions: PTC occurs more in middle-aged women between 40 and 60 years old, initiates as HFS, and affects the left side. Vertebrobasilar artery compression is the most common single cause of PTC. Microvascular decompression effectively treated PTC, with a cure rate >80%. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement predicts successful surgery and older age predicts recurrence.

Keywords: Hemifacial spasm; Microvascular decompression; Painful tic convulsif; Trigeminal neuralgia.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Data Analysis
Hemifacial Spasm / diagnosis*
Hemifacial Spasm / epidemiology*
Hemifacial Spasm / surgery
Humans
Pain / diagnosis
Pain / epidemiology
Pain / etiology
Prognosis
Syndrome
Tic Disorders / diagnosis*
Tic Disorders / epidemiology*
Tic Disorders / surgery
Trigeminal Neuralgia / diagnosis*
Trigeminal Neuralgia / epidemiology*
Trigeminal Neuralgia / surgery