Combined hyperactive dysfunction syndrome of the cranial nerves complicated by essential hypertension

Abstract

Rationale:Combined hyperactive dysfunction syndrome (HDS) refers to a special type of HDS characterized by a combination of trigeminal neuralgia (TN), hemi facial spasm (HFS), and/or gloss pharyngeal neuralgia (GPN). Rostra ventrolateral medulla (RVLM) plays a crucial role in central cardiovascular regulation, and neurovascular compression of the RVLM has been identified as a contributor to essential hypertension.Patient concerns:A 65-year-old female with a facial tic and pain located in the root of the tongue and throat on the same side; the systolic and diastolic blood pressure was approximately 170 and 100 mmHg.Diagnosis:The patient was diagnosed with combined HDS (HFS-GPN) and essential hypertension. Brain magnetic resonance 3-dimensional time-of-flight imaging and digital subtraction angiography revealed vertebrobasilar artery compressed the left RVLM and contacted with the root entry zones of multiple cranial nerves.Interventions:The patient was treated with microvascular decompression surgeryOutcomes:The symptoms were completely relieved, and blood pressure was well-controlled.Lessons:The pathological association of hypertension and HDS should be highlighted, and microvascular decompression is an effective approach for relieving the hypertension.