Combined Hyperactive Dysfunction Syndrome of the Cranial Nerves: A retrospective systematic study of clinical characteristics in 44 patients

Abstract Background Combined hyperactive dysfunction syndrome (HDS) is defined as the combination symptoms arising from overactivity in cranial nerves specifically, trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN) without an obvious explanatory structural lesion. The study aims to retrospectively analyze the clinical characteristics of combined HDS treated with microvascular decompression (MVD) in a single institution. Methods A total of 1450 patients with HDS were treated with MVD in our department during a 10–year period, among which 44 cases of combined HDS were identified. Clinical records and follow–ups were reviewed. Results Combined HDS comprised 3.03% (44/1450) of all HDS in our series, with female predominance compared with single HDS (p=0.002), including combined TN–HFS (14 cases), combined TN–GPN (26 cases), bilateral TN (2 cases), and combined TN–HFS–GPN (2 cases). The average age at diagnosis of combined HDS (60.9 y) was significantly older than that of single HDS (53.5 y), p=0.035. Hypertension was closely associated with the prevalence of combined HDS compared with single HDS (p=0.009). The curative rate was 97.7% (43/44) after MVD, and the recurrence rate was 3.33%. The incidence rates of postoperative cardiac, pulmonary, thromboembolic, and delirium complications were higher in combined HDS than in single HDS (p