eMedicine Specialties > Neurology > Headache and Pain

Raeder Paratrigeminal Syndrome: Differential Diagnoses & Workup

Author: Steven H Schechter, MD, Clinical Assistant Professor, Department of Neurology, Wayne State University School of Medicine; Consulting Staff, Division of Neurology, Assistant Medical Director of Stroke Unit, William Beaumont Hospital
Contributor Information and Disclosures

Updated: Sep 11, 2008

Differential Diagnoses

Arteriovenous Malformations
Head Injury
Aseptic Meningitis
HIV-1 Associated Cerebrovascular Complications
Benign Skull Tumors
Meningioma
Blood Dyscrasias and Stroke
Migraine Headache
Cardioembolic Stroke
Neurosarcoidosis
Cavernous Sinus Syndromes
Neurosyphilis
Cerebral Aneurysms
Persistent Idiopathic Facial Pain
Chronic Paroxysmal Hemicrania
Pituitary Tumors
Cluster Headache
Trigeminal Neuralgia
Craniopharyngioma
Tuberculous Meningitis
Dissection Syndromes
Fibromuscular Dysplasia

Other Problems to Be Considered

Brainstem syndromes
Granulomatous angiitis of the central nervous system
Carotid disease and stroke

Workup

Laboratory Studies

  • While most cases of Raeder paratrigeminal syndrome are benign, a thorough evaluation to exclude secondary causes may be warranted, particularly if parasellar nerve involvement is evident.
  • Basic laboratory analysis to evaluate for inflammatory or infectious etiologies also may be warranted.
  • A basic chemistry profile, CBC count, erythrocyte sedimentation rate, antinuclear antibody, and rheumatoid factor may be helpful in screening for inflammatory or infectious causes.

Imaging Studies

  • The neurodiagnostic evaluation should include magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain. These studies help to exclude secondary causes such as dissection, vascular anomaly, or aneurysm.
  • Cerebral arteriography may be considered if clinically indicated or if MRA findings warrant further evaluation.

More on Raeder Paratrigeminal Syndrome

Overview: Raeder Paratrigeminal Syndrome
Differential Diagnoses & Workup: Raeder Paratrigeminal Syndrome
Treatment & Medication: Raeder Paratrigeminal Syndrome
Follow-up: Raeder Paratrigeminal Syndrome
Multimedia: Raeder Paratrigeminal Syndrome
References

References

  1. Goadsby PJ. Raeder's syndrome [corrected]: paratrigeminal paralysis of the oculopupillary sympathetic system. J Neurol Neurosurg Psychiatry. Mar 2002;72(3):297-9. [Medline].

  2. Murnane M, Proano L. Raeder's paratrigeminal syndrome: a case report. Acad Emerg Med. Sep 1996;3(9):864-7. [Medline].

  3. Nolph MB, Dion MW. Raeder's syndrome associated with internal carotid artery dilation and sinusitis. Laryngoscope. Oct 1982;92(10 Pt 1):1144-8. [Medline].

  4. BONIUK M, SCHLEZINGER NS. Raeder's paratrigeminal syndrome. Am J Ophthalmol. Dec 1962;54:1074-84. [Medline].

  5. Law WR, Nelson ER. Internal carotid aneurysm as a cause of Raeder's paratrigeminal syndrome. Neurology. Jan 1968;18(1 Pt 1):43-6. [Medline].

  6. Grimson BS, Thompson HS. Raeder's syndrome. A clinical review. Surv Ophthalmol. Jan-Feb 1980;24(4):199-210. [Medline].

  7. Vijayan N, Watson C. Pericarotid syndrome. Headache. Nov 1978;18(5):244-54. [Medline].

  8. Raeder JG. "Paratrigeminal" paralysis of oculo-pupillary sympathetic. Brain. 1924;47:149-158.

  9. Selky AK, Pascuzzi R. Raeder's paratrigeminal syndrome due to spontaneous dissection of the cervical and petrous internal carotid artery. Headache. Jul-Aug 1995;35(7):432-4. [Medline].

  10. Appen RE, Sturm RJ. Raeder's paratrigeminal syndrome. Ann Ophthalmol. Sep 1978;10(9):1181-7. [Medline].

  11. Bajwa ZH, Ho CC. Causes of Facial Pain. UpToDate. Available at www.uptodate.com. Accessed 2004.

  12. Solomon S. Raeder syndrome. Arch Neurol. Apr 2001;58(4):661-2. [Medline].

Further Reading

Keywords

Raeder's paratrigeminal syndrome, facial pain, oculosympathetic palsy, Raeder's syndrome, paratrigeminal neuralgia, unilateral face pain, Horner syndrome, ipsilateral oculosympathetic palsy, paratrigeminal oculosympathetic syndrome

Contributor Information and Disclosures

Author

Steven H Schechter, MD, Clinical Assistant Professor, Department of Neurology, Wayne State University School of Medicine; Consulting Staff, Division of Neurology, Assistant Medical Director of Stroke Unit, William Beaumont Hospital
Steven H Schechter, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Medical Electroencephalographic Association, Michigan State Medical Society, and Oakland County Medical Society
Disclosure: Eli Lilly Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; Forest Honoraria Speaking and teaching

Medical Editor

Jorge E Mendizabal, MD, Consulting Staff, Corpus Christi Neurology
Jorge E Mendizabal, MD is a member of the following medical societies: American Academy of Neurology, American Headache Society, National Stroke Association, and Stroke Council of the American Heart Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

James H Halsey, MD, Professor, Department of Neurology, University of Alabama Medical Center
James H Halsey, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neuroimaging, Medical Association of the State of Alabama, New York Academy of Sciences, Pan American Medical Association, Sigma Xi, Society for Neuroscience, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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