Paratrigeminal Syndrome

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Classification according to ICD-10
G50.8 Other diseases of the trigeminal nerve
ICD-10 online (WHO version 2019)

The Paratrigeminale syndrome or Raeder's syndrome is a paratrigeminale neuralgia or paratrigeminale paralysis of the sympathetic nervous system .

The name refers to the first author of the first description from 1918 by the Norwegian ophthalmologist Johan Georg Raeder (1889-1959).

root cause

It is usually caused by a lesion between the sella and the ganglion gasseri .

Clinical manifestations

Clinical criteria are:

  • Morning violent migraine-like, boring, pulsating unilateral headache with nausea and vomiting
  • Dysesthesia
  • subsiding towards noon
  • on the same page Horner syndrome without anhidrosis

There is also paralysis of other cranial nerves .

Diagnosis

The diagnosis is carried out by means of an ophthalmological examination, a cranial computed tomography (CCT) or cranial magnetic resonance tomography (MRT; including representation of the orbit ), duplex sonography of the craniocervical arteries and / or MR angiography . This is to exclude lesions in the course of the internal carotid artery (arterial dissection, aneurysm in the area of ​​the siphon loop). Alternatively, conventional cerebral angiography is performed.

therapy

If no cause is found, corticosteroids are used, to which some of the patients respond spontaneously.

Differential diagnosis

The following are to be distinguished:

Other forms of trigeminal neuralgia , Bonnier syndrome , Gradenigo syndrome , neuralgia due to tumors of the ethmoid or sphenoid sinuses , internal carotid artery syndrome or Charlin syndrome .

literature

  • MM Shoja, RS Tubbs, K. Ghabili, M. Loukas, WJ Oakes, AA Cohen-Gadol: Johan Georg Raeder (1889-1959) and paratrigeminal sympathetic paresis. In: Child's nervous system: ChNS: official journal of the International Society for Pediatric Neurosurgery. Vol. 26, No. 3, March 2010, pp. 373-376, doi: 10.1007 / s00381-009-0965-9 , PMID 19705130 .
  • V. Kirkova, A. Andreeva, S. Cherninkova et al .: RAEDER PARATRIGEMINAL Syndrome In A Patient With A Mass Lesion In Tth Maxillary Sinus. In: Journal of IMAB Vol. 16, No. 3, 2010, p. 68, [doi] 0.5272 / jimab.1632010_38-39, [1]
  • R. Salvesen: Raeder's syndrome. In: Cephalalgia: an international journal of headache. Vol. 19 Suppl 25, December 1999, pp. 42-45, PMID 10668120 .
  • M. Murnane, L. Proano: Raeder's paratrigeminal syndrome: a case report. In: Academic Emergency Medicine. Vol. 3, No. 9, September 1996, pp. 864-867, PMID 8870759 .

JG Raeder: "Paratrigeminal" paralysis of oculo-pupillary sympathetic. In: Brain. Vol. 47, 1924, pp. 149-158.

Individual evidence

  1. ↑ a b c d Bernfried Leiber (founder): The clinical syndromes. Syndromes, sequences and symptom complexes . Ed .: G. Burg, J. Kunze, D. Pongratz, PG Scheurlen, A. Schinzel, J. Spranger. 7., completely reworked. Edition. tape 2 : symptoms . Urban & Schwarzenberg, Munich et al. 1990, ISBN 3-541-01727-9 .
  2. ^ JG Raeder: Et tilfælde av intrakraniel sympaticuslammelse. In: Norsk Magazin for Lægevidenskaben , Vol. 79, 1918, pp. 999-1016
  3. ↑ Karl Zeiler, Eduard Auff, Lüder Deecke: Clinical Neurology I: Fundamentals for human and dental medicine . Facultas Verlags- und Buchhandels AG, February 1, 2006, ISBN 978-3-99030-097-8 , pp. 190–.

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