【省立疼痛英语晨读】一例病例报告和文献回顾：舌咽神经痛并发喉咽痉挛（HeLPS）（一）

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本次文献选自Honey CM: Concurrent Glossopharyngeal Neuralgia and Hemi-Laryngopharyngeal Spasm (HeLPS): A Case Report and a Review of the Literature. Neurosurgery.2019.12:nyz546.

BACKGROUND AND IMPORTANCE: 

Hemi-laryngopharyngeal spasm (HeLPS) has been recently described but is not yet widely recognized. Patients describe intermittent coughing and choking and can be cured following microvascular decompression of their Xth cranial nerve. This case report and literature review highlight that HeLPS can co-occur with glossopharyngeal neuralgia (GN) and has been previously described (but not recog-nized) in the neurosurgical literature.

背景与重要性：

喉咽痉挛（HeLPS）近来已有报道，但尚未得到广泛认可。患者表现为间歇性咳嗽和窒息，可在其第X颅神经微血管减压后治愈。该病例报告和文献综述强调了HeLPS可以与舌咽神经痛（GN）同时发生，并且在神经外科文献中已有报道（但未被认可）。

CLINICAL PRESENTATION: 

A patient with GN and additional symptoms compatible with HeLPS is presented. The patient reported left-sided, intermittent, swallow-induced, severe electrical pain radiating from her ear to her throat (GN). She also reported intermittent severe coughing, throat contractions causing a sense of suffocation, and dysphonia (HeLPS). All her symptoms resolved following a left microvascular decompression of a loop of the posterior inferior cerebellar artery that was pulsating against both the IXth and Xth cranial nerves. A review of the senior author’s database revealed another patient with this combination of symptoms. An international literature review found 27 patients have been previously described with symptoms of GN and the additional (but not recognized at the time) symptoms of HeLPS.

临床表现：

本文介绍了一名患有GN和其他症状且合并HeLPS的患者。患者自诉疼痛是由吞咽引起，从左耳到喉咙（GN）放射，呈间歇性，疼痛性质为闪电样、重度疼痛。她还自诉有严重间歇性咳嗽、以及喉咙收缩导致的窒息感和发声障碍（HeLPS）。她的所有症状在小脑后下动脉环左侧微血管减压术后消失，此动脉环搏动压迫第IX和第X颅神经。对高级作者数据库的回顾显示，另一名患者也出现了这种症状。一项国际文献综述发现，先前已经报道了27例具有GN症状和HeLPS症状（但当时尚未发现）的患者。

CONCLUSION: 

This review highlights that patients with symptoms compatible with HeLPS have been reported since 1926 in at least 4 languages. This additional evidence supports the growing recognition that HeLPS is another neurovascular compression syndrome. Patients with HeLPS continue to be misdiagnosed as conversion disorder. The increased recognition of this new medical condition will require neurosurgical treatment and should alleviate the suffering of these patients.

结论：

本综述发现自1926年以来已有至少4种语言报道了合并HeLPS的GN的患者。这些额外的证据支持人们越来越认识到HeLPS是另一种神经血管压迫综合征。然而，HeLPS患者继续被误诊为转化障碍。对这种新医学状况的日益认识将需要神经外科治疗，并应减轻这些患者的痛苦。