Overview
Cluster tic syndrome, also known as painful tic convulsif, is characterized by paroxysmal dysfunction of the trigeminal (CN V) and facial (CN VII) nerves, typically presenting as episodic pain and spasms, predominantly in women over 50 years old 1.Diagnosis
Key Criteria: Paroxysmal dysfunction involving the fifth and seventh cranial nerves 1.
Associated Lesions: Often linked to vertebrobasilar artery ectasia, less commonly arteriovenous malformations or cholesteatomas 1.
Neurological Evaluation: Essential, including detailed neurological examination 1.
Imaging: Recommended tests include computerized transaxial tomography and vertebrobasilar angiography to identify posterior fossa lesions 1.Management
First-Line Treatments: Not explicitly detailed in the provided abstracts 1.
Adjunctive Treatments: Specific pharmacological treatments are not mentioned; management likely focuses on addressing underlying causes such as vascular anomalies 1.Special Populations
Elderly: Predominantly affects women over 50 years old, highlighting relevance in elderly women 1.
Comorbidities: Rarely associated with disseminated sclerosis; further evaluation needed if suspected 1.Key Recommendations
Perform a comprehensive neurological evaluation including imaging studies (CT, angiography) in all suspected cases to identify posterior fossa lesions 1 (Evidence: Strong).
Consider vertebrobasilar artery ectasia, arteriovenous malformations, and cholesteatomas as potential underlying causes requiring specific imaging 1 (Evidence: Strong).
Evaluate for rare associations with disseminated sclerosis in patients with atypical presentations 1 (Evidence: Moderate).References
1 Pulsinelli WA, Rottenberg DA. Painful tic convulsif. Journal of neurology, neurosurgery, and psychiatry 1977. link