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PT  - JOURNAL ARTICLE
AU  - Avecillas-Chasin, J.
AU  - Kozoriz, M.G.
AU  - Shewchuk, J.R.
AU  - Heran, M.K.S.
AU  - Honey, C.R.
TI  - Imaging and Surgical Findings in Patients with Hemi-Laryngopharyngeal Spasm and the Potential Role of MRI in the Diagnostic Work-Up
AID  - 10.3174/ajnr.A5851
DP  - 2018 Dec 01
TA  - American Journal of Neuroradiology
PG  - 2366--2370
VI  - 39
IP  - 12
4099  - http://www.ajnr.org/content/39/12/2366.short
4100  - http://www.ajnr.org/content/39/12/2366.full
SO  - Am. J. Neuroradiol.2018 Dec 01; 39
AB  - BACKGROUND AND PURPOSE: Hemi-laryngopharyngeal spasm is a recently discovered condition characterized by episodic coughing and unilateral throat contractions that may lead to severe stridor. These symptoms are caused by a vascular compression of the ipsilateral vagus nerve, typically the PICA. Microvascular decompression of the vagus nerve has been demonstrated to be a potential cure for this neurovascular compression syndrome. The main aim of this study was to clarify the role of MR imaging in the diagnostic work-up of this rare condition.MATERIALS AND METHODS: We describe the imaging and surgical findings of 3 patients from our prospective case series of patients with hemi-laryngopharyngeal spasm from 2015 to 2017. Second, the imaging data of 100 patients (control cohort) with symptoms unrelated to hemi-laryngopharyngeal spasm were reviewed to investigate the rate and degree of neurovascular conflict of the vagus nerve.RESULTS: All patients with hemi-laryngopharyngeal spasm reported to date have had vascular compression of the vagus nerve due to the PICA. In the control cohort, there was a good interrater agreement in scoring the “contact” and “compression” of the vagus nerve (κ = 0.73. P = &amp;lt; .001). The frequency of contact or compression of the vagus nerve was approximately 50%. The PICA was the most frequent vessel involved in 74%.CONCLUSIONS: The presence of unilateral neurovascular contact or compression of the vagus nerve does not confirm the diagnosis of hemi-laryngopharyngeal spasm. The MR imaging finding of ipsilateral vascular compression of the vagus nerve is a necessary but not sufficient finding for the diagnosis of hemi-laryngopharyngeal spasm.HELPShemi-laryngopharyngeal spasmMVDmicrovascular decompression