Aiko Maeda1, Kenzo Araki2, Chiaki Yamada2, Shoko Nakayama3, Kazuhiro Shirozu4, Ken Yamaura4. 1. Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, 3-1-1 Maedashi Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan. maeda.aiko.461@m.kyushu-u.ac.jp. 2. Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, 3-1-1 Maedashi Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan. 3. Operating Rooms, Kyushu University Hospital, Fukuoka, Japan. 4. Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
Abstract
BACKGROUND: Hyperactive dysfunction syndrome (HDS) refers to a constellation of symptoms developing from cranial nerve overactivity caused by neurovascular compression at the root entry or exit zone near the brainstem. Although the combined features of HDS are seen in the elderly, there are no reports of such cases in adolescents, to date. CASE PRESENTATION: A 17-year-old male was diagnosed with right glossopharyngeal neuralgia and treated with microvascular decompression. He experienced new-onset right facial pain later and was diagnosed with right trigeminal neuralgia, which required prompt radiofrequency thermocoagulation of the right mandibular nerve. Follow-up in the third post-treatment year revealed the absence of symptom recurrence. DISCUSSION: We report the treatment of a rare case of adolescent-onset combined HDS presenting as trigeminal and glossopharyngeal neuralgia. This report highlights the possibility of combined hyperactive dysfunction syndrome in younger age groups. It is crucial to establish a diagnosis early on for prompt management.
BACKGROUND:Hyperactive dysfunction syndrome (HDS) refers to a constellation of symptoms developing from cranial nerve overactivity caused by neurovascular compression at the root entry or exit zone near the brainstem. Although the combined features of HDS are seen in the elderly, there are no reports of such cases in adolescents, to date. CASE PRESENTATION: A 17-year-old male was diagnosed with right glossopharyngeal neuralgia and treated with microvascular decompression. He experienced new-onset right facial pain later and was diagnosed with right trigeminal neuralgia, which required prompt radiofrequency thermocoagulation of the right mandibular nerve. Follow-up in the third post-treatment year revealed the absence of symptom recurrence. DISCUSSION: We report the treatment of a rare case of adolescent-onset combined HDS presenting as trigeminal and glossopharyngeal neuralgia. This report highlights the possibility of combined hyperactive dysfunction syndrome in younger age groups. It is crucial to establish a diagnosis early on for prompt management.