• Brian A Simpson, Anthony Amato-Watkins, and Margaret D Hourihan.
• Department of Neurosurgery, University Hospital of Wales, Cardiff, UK. Electronic address: briansimpson48@btinternet.com.
• Pain. 2014 Aug 1;155(8):1667-72.

AbstractMicrovascular decompression (MVD) of cranial nerves has become an established treatment for trigeminal and (vago)glossopharyngeal neuralgia and for hemifacial spasm. The authors present the case of a 64-year-old man who had a 3.5-year history of severe, drug-resistant hemibody pain with sensory and autonomic disturbance. The ipsilateral trigeminal, cochlear, and glossopharyngeal function also was affected. The contralateral posterior inferior cerebellar artery was seen on magnetic resonance imaging to be indenting the caudal medulla anterolaterally, causing displacement. After MVD of the medulla, there was an immediate and complete resolution of the pain and almost complete resolution of the sensory and autonomic disturbances. The pain later recurred mildly and transiently. The residual symptoms had resolved by 2 years.Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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