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Raeder syndrome: Paratrigeminal oculosympathetic syndrome presenting as a manifestation of chronic sinusitis.

Ear Nose Throat J

December 2015

Division of Laryngology, Rhinology, and General Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, 1904 Taubman Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5312, USA.

Raeder syndrome (paratrigeminal oculosympathetic syndrome) is a rare clinical entity characterized by ipsilateral trigeminal sensory deficits, ptosis, and miosis, with an absence of anhidrosis secondary to interruption of the postganglionic oculosympathetic pathway. Going back to its original description, this constellation of physical examination findings has historically been associated with intracranial pathology involving the middle cranial fossa. Understanding this pathway is important in distinguishing Raeder syndrome from Horner syndrome, as the presentation of the former is now recognized to accompany a number of other disease entities in the head and neck region.

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Purpose: Raeder paratrigeminal neuralgia is most commonly characterized as deep, boring, nonpulsatile, severe, unilateral facial and head pain in the distribution of the V1 area combined with ipsilateral oculosympathetic palsy and autonomic symptoms. Raeder paratrigeminal neuralgia evolving into hemicrania continua, a rare primary, chronic headache syndrome characterized by unilateral pain and response to indomethacin, has rarely been documented. The purpose of this case report is to contribute to the medical literature a single case of Raeder paratrigeminal neuralgia presenting as multiple cranial nerve palsies that evolved into hemicrania continua that was successfully treated with onabotulinumtoxinA.

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Neurologic syndromes of the head and neck.

Prim Care

March 2014

Department of Family & Community Medicine, University of Kansas School of Medicine - Wichita, 1010 North Kansas, Wichita, KS 67214, USA. Electronic address:

Although patients with Bell palsy and trigeminal neuralgia occasionally present to primary care physicians, most of the syndromes in this article are somewhat rare in primary care practice. It is important to recognize signs and symptoms of these syndromes so that appropriate management is carried out. Patients may experience sensory and/or motor symptoms of the head and neck due to disorders of the cranial and cervical nerves.

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Aneurysms of the petrous portion of the internal carotid artery (ICA) are rare. Their etiology is usually congenital, traumatic, or mycotic. Depending on the size and location of the aneurysm, the direction of its growth, and the specific adjacent structures involved, patients may or may not present with signs and symptoms.

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