Neuralgiformer Gesichtsschmerz nach Arteria-carotis-Endarterektomie: Das Eagle-Syndrom als seltene Differenzialdiagnose

Craniofacial pain may lead to an extensive differential diagnosis. A rare cause is Eagle's syndrome, which was first described in 1937. It is characterised by cranial and facial pain associated with the sensation of a foreign body in the pharynx. Typically, these complaints can be elicited by speaking, swallowing or cervical rotation. The symptoms, which may vary between individual patients, may be evoked by an abnormal length of the styloid process or calcification of the stylohyoid ligament. Due to their close anatomic relationship, they irritate the mandibular branch of the fifth cranial nerve and / or the intermediate nerve or even the caudal cranial nerves, respectively. Only a small number of patients with an abnormally prolonged styloid process develop Eagle's syndrome. In some of these cases the syndrome occurs spontaneously, in other cases it follows a local surgical or external trauma, probably due to individually different anatomic anomalies. In most of these symptomatic cases, the manifestation of Eagle's syndrome has been elicited by tonsillectomy. The case report presented here documents an Eagle syndrome following ipsilateral carotid endarterectomy. We discuss diagnostic criteria and therapeutic options for Eagle syndrome's, which may be underestimated as a reason for craniocervical neuralgic pain, since the symptoms of this entity are variable and non-specific at the first manifestation.