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    Eagle Syndrome An Unusual Cause of Head and Neck Pain

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    Cecilia Andersson
    With appropriate clinical history and radiography, Eagle syndrome can usually be identified and treated. Over-the-counter pain medications and valproate sodium were ineffective. Palpation of the styloid process in the tonsillar fossa indicates elongation.

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    Eagle Syndrome An Unusual Cause of Head and Neck Pain

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    Cecilia Andersson
    62 views2 pages
    With appropriate clinical history and radiography, Eagle syndrome can usually be identified and treated. Over-the-counter pain medications and valproate sodium were ineffective. Palpation of the styloid process in the tonsillar fossa indicates elongation.

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    With appropriate clinical history and radiography, Eagle syndrome can usually be identified and treated. Over-the-counter pain medications and valproate sodium were ineffective. Palpation of the styloid process in the tonsillar fossa indicates elongation.

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    Download as PDF, TXT or read online from Scribd
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    62 views2 pages

    Eagle Syndrome An Unusual Cause of Head and Neck Pain

    Uploaded by

    Cecilia Andersson
    With appropriate clinical history and radiography, Eagle syndrome can usually be identified and treated. Over-the-counter pain medications and valproate sodium were ineffective. Palpation of the styloid process in the tonsillar fossa indicates elongation.

    Copyright:

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    of 2

    IMAGES IN NEUROLOGY

    Eagle Syndrome
    An Unusual Cause of Head and Neck Pain

    E
    AGLE SYNDROME IS COMMENT Though already known to oto-
    characterized by re- laryngologists, we hope to increase
    current pain in the Eagle syndrome comprises clinical awareness of Eagle syndrome among
    oropharynx and face symptoms arising from an elon- neurologists because it is a treat-
    due to an elongated gated styloid process or calcified able entity different from glossopha-
    styloid process or calcified stylohy- stylohyoid ligament. Otolaryn- ryngeal neuralgia.
    oid ligament.1 It must be differenti- gologist W. W. Eagle described
    ated from glossopharyngeal neural- the syndrome in 1937 based on Christina K. Sun, MD
    gia. We aim to bring Eagle syndrome review of previous communica- Vince Mercuri, MMed, FRANCZR
    to the attention of neurologists be- tions and personal cases. 2 Com- Mark J. Cook, MD, FRACP
    cause it is underrepresented in neu- plaints include throat pain, for-
    rological literature. We present a case eign body sensation, dysphagia,
    of a man with left mastoid pain; com- and facial pain,1 often radiating to Correspondence: Dr Sun, Depart-
    puted tomographic scan revealed ex- the mastoid or ear.3 Syncope has ment of Neurology, Centre for Clini-
    tensive stylohyoid ligament ossifi- also been reported.3 Diagnosis is cal Neurosciences and Neurologi-
    cation bilaterally. With appropriate based on history, clinical exami- cal Research, St Vincent’s Hospital
    clinical history and radiography, nation, and radiography. Palpa- Melbourne, PO Box 2900, Fitzroy
    Eagle syndrome can usually be iden- tion of the styloid process in the VIC 3065, Australia (christinaksun
    tified and treated. tonsillar fossa indicates elongation @yahoo.com).
    because normal processes are not Author Contributions: Study con-
    palpable.1 Panoramic radiography cept and design: Sun and Cook. Ac-
    REPORT OF A CASE
    of the mouth or computed tomog- quisition of data: Mercuri. Analysis
    raphy of the skull base and neck and interpretation of data: Sun and
    A 25-year-old man was seen with 3 are the preferred radiographic Mercuri. Drafting of the manuscript:
    years of left mastoid pain radiating studies. 4 Medical management Sun. Critical revision of the manu-
    to the ear. The pain was constant and includes analgesics, anticonvul- script for important intellectual con-
    aching; it peaked over minutes and sants, antidepressants, and local tent: Mercuri and Cook. Administra-
    lasted days. Mouth opening, sneez- infiltration with steroids or anes- tive, technical, and material support:
    ing, and head turning precipitated thetic agents. 4 Patients who fail Sun, Mercuri, and Cook.
    episodes. Head turning occasion- medical therapy may benefit from
    ally triggered presyncope. Neuro- surgical removal of the elongated REFERENCES
    logical examination and brain mag- portion of the styloid process.1
    netic resonance imaging were The pathophysiological mecha- 1. Murtagh RD, Caracciolo JT, Fernandez G. CT find-
    unremarkable. Diagnosis was sus- nisms contributing to Eagle syn- ings associated with eagle syndrome. AJNR Am J
    pected based on clinical history. drome remain controversial and Neuroradiol. 2001;22:1401-1402.
    2. Eagle WW. Elongated styloid processes: report of
    Head computed tomography re- include glossopharyngeal nerve two cases. Arch Otolaryngol. 1937;25:584-587.
    vealed extensive stylohyoid liga- compression, pharyngeal mucosa 3. Bruyn GW. Stylohyoid syndrome (Eagle). In: Vinken
    ment ossification bilaterally irritation by posttonsillectomy PJ, Bruyn GW, Klawans HL, Rose FC, eds. Hand-
    (Figure). Over-the-counter pain scarring, and callus formation book of Clinical Neurology. Vol 4. Amsterdam, the
    medications and valproate sodium from prior styloid fracture. 1 Netherlands: Elsevier Science Publishers BV; 1986:
    501-514.
    were ineffective, though local hot- Carotid vessel impingement and 4. Slavin KV. Eagle syndrome: entrapment of the glos-
    pack application provided improve- irritation of sympathetic nerves sopharyngeal nerve? case report and review of the
    ment. The patient refused surgery. have also been proposed.3 literature. J Neurosurg. 2002;97:216-218.

    (REPRINTED) ARCH NEUROL / VOL 63, FEB 2006 WWW.ARCHNEUROL.COM


    294

    ©2006 American Medical Association. All rights reserved.


    A B

    Figure. Reformatted coronal maximum intensity projection image (A) and volume-rendered reconstruction in bone window (B) of the upper neck data set,
    demonstrating near-complete stylohyoid ligament (arrows) ossification, extending from the styloid process tip to the lesser cornu of the hyoid bone bilaterally.

    (REPRINTED) ARCH NEUROL / VOL 63, FEB 2006 WWW.ARCHNEUROL.COM


    295

    ©2006 American Medical Association. All rights reserved.

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