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Lower Cranial Nerve Dysfunction

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Brought to you by the Residents & Fellows Section of Neurology®.

December 18, 2014

Ipsilateral dysfunction of the lower four cranial nerves and the cervical sympathetic trunk can produce a stereotyped constellation of symptoms, termed Villaret’s syndrome. First described by the French neurologist, Maurice Villaret, in 1916, patients can present with dysphonia, dyshpagia, and changes in taste sensations [1]. Exam findings will confirm palsies of cranial nerves IX, X, XII, and XII, with a concomitant Horner’s syndrome. Villaret’s syndrome is produced by lesions in the posterior retropharyngeal space, localizing to the area near the mastoid process, internal carotid artery and internal jugular vein, wherein the last four cranial nerves course [2]. Etiologies include traumatic and compressive lesions such as nasopharyngeal and parotid tumors, abscesses, and aneurysms of the internal carotid artery.  

References

  1. Tiliket C, Petiot R, Arpin D, et al. Clinical and radiologic aspects of Villaret’s syndrome. Clin Neurol Neurosurg 1996; 98: 194-196.
  2. Garrett D Jr, Ansell LV, and Story JL. Villaret’s syndrome: a report of two cases. Surg Neurol 1993; 39: 282-285.

Submitted by Dr. Adam Numis.

Dr. Numis is a member of the Resident and Fellow Section of Neurology

For more clinical pearls and other articles of interest to neurology trainees, visit the Neurology Residents & Fellows page.  Listen to this week's Neurology Podcast.

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