Ræder's Syndrome

Abstract

Raeder's syndrome was first described by the Norwegian ophthalmologist J. G. Raeder in 1918, and the description extended in 1924 by the same author. The seminal report was a description of a young, male patient with unilateral periocular pain combined with ipsilateral miosis and ptosis, and with slight objective signs of trigeminal nerve involvement. Autopsy demonstrated a tumor at the base of the skull in the middle cranial fossa. The term "paratrigeminal" was coined for the picture reported. Later case reports by the same and other authors have included patients with a more benign clinical course, including spontaneous remissions, with unilateral periocular pain and ipsilateral signs of oculosympathetic paresis as the common denominator. This review is a chronological survey of the main contributions that have appeared in the literature and an outline of the various definitions of the syndrome, including a recent classification as well as some pathophysiological and prognostic considerations.

Selective Damage of Trigeminal Aδ Fibres in Raeder'S Syndrome Following Dissection of the ICA Detected by A Nociceptive Blink Reflex

“…In 1918 and 1924, the Norwegian opthalmologist Georg Raeder described a syndrome of unilateral headache, facial pain and incomplete Horner's syndrome (3). Expansive pericarotid lesions such as tumours, fibromuscular dysplasia or aneurysm can lead to direct compressive injury of the trigeminal nerve (1). Also carotid artery dissection extending into the intracavernous segment raises the possibility of ‘mechanical’ involvement of trigeminal fibres.…”

“…Raeder's paratrigeminal syndrome is described as unilateral head and face pain, ipsilateral oculo‐sympathetic paralysis (Horner's syndrome) and ipsilateral trigeminal dysfunction or less frequently dysfunction of other cranial nerves (1). We present a rare case of Raeder's syndrome following a dissection of the petrous part of the internal carotid artery (ICA) with selective damage of Aδ fibres of the ophthalmic part of trigeminal nerve , confirmed by eliciting the nociception specific blink reflex (nBR) with a new concentric electrode that selectively recruits cutaneous trigeminal Aδ fibres and is therefore specific to changes in trigeminal nociception (2).…”

Headache and the eye

“…Paratrigeminal oculosympathetic syndrome (Raeder's paratrigeminal neuralgia) is an uncommon benign neurologic disorder characterized by unilateral periocular pain and ipsilateral postganglionic Horner's secondary to involvement of the oculosympathetic fibers along the course of the internal carotid artery [32,33]. Idiopathic lesions of the middle cranial fossa should be excluded [34].…”

Raeder Paratrigeminal Neuralgia Evolving to Hemicrania Continua

“…1Y3 Ptosis, miosis, and hydrosis of the V 1 area distinguish Raeder syndrome from Horner syndrome, which typically presents with anhidrosis. 8 Onset has been reported in the second through the eighth decades, although it appears to be most prevalent between the ages of 40 and 50 years. 6 Various cranial nerve deficiencies (II to VI) may be involved, 7 with a typical expectation of trigeminal nerve involvement.…”

“…6 Various cranial nerve deficiencies (II to VI) may be involved, 7 with a typical expectation of trigeminal nerve involvement. 6,8 There has been one report of Raeder syndrome associated with Lyme disease. Male sex appears to dominate.…”