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

Background Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity not yet been systematically studied.Objective To systematically explore the epidemiology, cause, prognosis, and prognosis predictors of PTC.Method We searched PubMed, Web of Science, and the Cochrane Library for relevant studies published between the library establishment time and July 1st, 2020. Information on demographics, causes, specific interventions, and intervention outcomes was extracted. We first made descriptive analyses for demographics, causes, and surgical outcomes of PTC. Univariate and multivariate regression methods were utilized to explore potential prognosis predictors. Further, a two-step meta-analysis method was employed to validate the identified factors.Results Overall, 57 reports including 192 cases with PTC were included in the analysis. The median age of PTC patient is 54 (44-62), with more patients being female (p < 0.001), initiated as HFS (p = 0.005), and affected left side (p = 0.045). Vertebrobasilar artery (VBA) contributes to over-65% of the causes of single vascular compression for PTC. Anterior inferior cerebellar artery (AICA)/posterior inferior cerebellar artery (PICA) involvement (OR = 4.050, 95% CI = 1.091-15.031) and older age (p = 0.008) predicts symptom-free and recurrence after microvascular decompression (MVD), respectively.Conclusions PTC more occurs in middle-age women between 40 to 60, initiates as HFS, and affects left side. VBA compression is the most common single cause for PTC. MVD could effectively treat PTC with an over-80% cure rate. AICA/PICA involvement predicts successful surgery and older age predicts recurrence.Registration: the protocol of this study is registered in the Open Science Framework (DOI 10.17605/OSF.IO/X9G3R) on July 10th, 2020.