Diagnostic Considerations
The differential diagnosis of Raeder paratrigeminal syndrome is broad; it includes the following conditions [19, 20] :
-
Carotid body tumor
-
Cerebral vascular dissection
-
Cluster headache
-
Craniopharyngioma
-
Dissection syndromes
-
Fibromuscular dysplasia
-
Head Injury
-
Human immunodeficiency virus 1 (HIV-1)–associated cerebrovascular complications
-
Lyme disease
-
Meningioma
-
Middle cranial fossa tumors
-
Migraine headache
-
Neurosarcoidosis
-
Neurosyphilis
-
Osteitis
-
Persistent idiopathic facial pain
-
Pituitary tumors
-
Sinusitis
-
Syphilis
-
Trauma
-
Trigeminal neuralgia
-
Tuberculous meningitis
-
Brainstem syndromes
-
Granulomatous angiitis of the central nervous system
-
Carotid disease and stroke
With the addition of parasellar cranial involvement, a mass lesion in this area should be considered. [10] Horner syndrome is an additional consideration.
Differential Diagnoses
-
Lyme Disease should also be considered in the differential diagnosis when other etiologies have been excluded.
-
sinusitis
Bacterial sinusitis may also present with Raeder Syndrome and should be considered in the differential diagnosis
-
Cervical sympathetic pathway, including oculosympathetic fibers. A lesion at A would produce a complete Horner syndrome with ipsilateral loss of facial sweating; a lesion at B would produce oculosympathetic paresis, but with preserved facial sweating. Reprinted with permission (Hanley and Belfus, Inc. Academic Emergency Medicine 1996; 3(9); 864-867.)
-
Evident in this patient are the mild ptosis of the left upper eyelid, the slight elevation of the left lower eyelid, and the miosis of the left eye. Reprinted with permission (Copyright American Society of Contemporary Ophthalmology. Annals of Ophthalmology 1978; 10(9); 1181-1187.)
