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Eagle’s syndrome: a pain in the neck

Síndrome de Eagle: um diagnóstico difícil

A 60-year-old male patient was evaluated for cervical pain, hiccups, dysphonia and dysphagia for five months. Physical examination showed left IX and X cranial nerve palsy. Brain MRI was normal. A cervical CT scan showed an elongated styloid process and stylohyoid ligament pseudoarthrosis (Figure). Eagle’s syndrome is a rare entity caused by abnormal enlargement and ossification of the styloid process, the attached stylohyoid ligament and the lesser cornu of the hyoid bone11. Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012; pii: bcr2012006278. http://doi.org/10.1136/bcr-2012-006278
http://doi.org/10.1136/bcr-2012-006278...
,22. Costantinides F, Vidoni G, Bodin C, Di Lenarda R. Eagle’s syndrome: signs and symptoms. Cranio.. 2013;31(1):56-60. http://doi.org/10.1179/crn.2013.008
http://doi.org/10.1179/crn.2013.008...
,33. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26. http://doi.org/10.1007/s00701-012-1385-2
http://doi.org/10.1007/s00701-012-1385-2...
,44. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58. http://doi.org/10.1002/ca.20804
http://doi.org/10.1002/ca.20804...
. The condition causes variable degrees of compression of V, VII, IX, X and XII cranial nerves, and the jugular or carotid, leading to diverse symptoms11. Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012; pii: bcr2012006278. http://doi.org/10.1136/bcr-2012-006278
http://doi.org/10.1136/bcr-2012-006278...
,22. Costantinides F, Vidoni G, Bodin C, Di Lenarda R. Eagle’s syndrome: signs and symptoms. Cranio.. 2013;31(1):56-60. http://doi.org/10.1179/crn.2013.008
http://doi.org/10.1179/crn.2013.008...
,33. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26. http://doi.org/10.1007/s00701-012-1385-2
http://doi.org/10.1007/s00701-012-1385-2...
,44. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58. http://doi.org/10.1002/ca.20804
http://doi.org/10.1002/ca.20804...
. Eagle’s syndrome pathogenesis remains unclear11. Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012; pii: bcr2012006278. http://doi.org/10.1136/bcr-2012-006278
http://doi.org/10.1136/bcr-2012-006278...
,22. Costantinides F, Vidoni G, Bodin C, Di Lenarda R. Eagle’s syndrome: signs and symptoms. Cranio.. 2013;31(1):56-60. http://doi.org/10.1179/crn.2013.008
http://doi.org/10.1179/crn.2013.008...
,33. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26. http://doi.org/10.1007/s00701-012-1385-2
http://doi.org/10.1007/s00701-012-1385-2...
,44. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58. http://doi.org/10.1002/ca.20804
http://doi.org/10.1002/ca.20804...
.

Figure
Maximum intensity projection and 3D CT-scan volume rendering of the patient’s cervical region. Note bilateral calcification of the stylohyoid ligament.

References

  • 1
    Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012; pii: bcr2012006278. http://doi.org/10.1136/bcr-2012-006278
    » http://doi.org/10.1136/bcr-2012-006278
  • 2
    Costantinides F, Vidoni G, Bodin C, Di Lenarda R. Eagle’s syndrome: signs and symptoms. Cranio.. 2013;31(1):56-60. http://doi.org/10.1179/crn.2013.008
    » http://doi.org/10.1179/crn.2013.008
  • 3
    Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26. http://doi.org/10.1007/s00701-012-1385-2
    » http://doi.org/10.1007/s00701-012-1385-2
  • 4
    Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58. http://doi.org/10.1002/ca.20804
    » http://doi.org/10.1002/ca.20804
  • Support: Brazilian Government research grant agencies CNPq, FAPERGS and FIPE/HCPA. Bianchin MM is further supported by CNPq (#307084/2014-0).

Publication Dates

  • Publication in this collection
    Feb 2017

History

  • Received
    17 Aug 2016
  • Accepted
    10 Oct 2016
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