Collet-Sicard Syndrome
Overview
Collet-Sicard Syndrome, also known as Condylar Jugular Syndrome, describes a collection of ipsilateral cranial nerve palsies (IX, X, XI, and XII) as a result of injury or mass effect at the skull base.
History
Frederic Collet first described a World War I patient in 1915 with this constellation of cranial nerve palsies following a bullet injury.[1] This case presentation was seen again by Jean Sicard in 1917.[2]
Pathophysiology
Relevant Anatomy
Collet-Sicard syndrome is a result of injury or mass effect to cranial nerves IX, X, and XI at the jugular foramen (in isolation known as Vernet Syndrome), with the additional involvement of CN XII (most commonly at the hypoglossal canal). Readers should be familiar with the anatomy of the cranial nerves and their respective skull base foramina.
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Skull base foramina, superior and inferior views
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Skull base foramina
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Cranial Nerves IX, X, and XII exiting the skull base
Disease Etiology
The etiology of Collet-Sicard syndrome can be divided into neoplastic and non-neoplastic causes:
Neoplastic
Non-Neoplastic
- Trauma[6]
- Paget Disease
- Osteomyelitis of the Skull Base
- Vascular Disease
Diagnosis
Patient History
Physical Examination
Laboratory Tests
Imaging
Differential Diagnosis
There are several named syndromes differentiating the various cranial nerve deficits that can result from skull base masses and lesions. These should be considered based on cranial nerve involvement.
These syndromes and their respective cranial nerve involvement are outlined in the table below.
| Syndrome | CN IX | CN X | CN XI | CN XII | Sympathetics |
|---|---|---|---|---|---|
| Vernet Syndrome | ✔ | ✔ | ✔ | ||
| Collet-Sicard Syndrome | ✔ | ✔ | ✔ | ✔ | |
| Villaret Syndrome | ✔ | ✔ | ✔ | ✔ | ✔ |
| Tapia Syndrome | ✔ | ± | ✔ | ± | |
| Jackson Syndrome | ✔ | ✔ | ✔ | ||
| Schmidt Syndrome | ✔ | ✔ |
Management
Medical Management
Surgical Management
Outcomes
Complications
Prognosis
References
- ↑ Collet, F. J. (1915). Sur un nouveau syndrome paralytique pharyngo-larynge par blessure de guerre (hemiplegie glosso-laryngo-scapulo-pharyngee). Lyon Med, 124, 121-129.
- ↑ Sicard, J. A. (1917). Syndrome du carrefour condylodechire posterieur (type pur de paralysie laryngee associee). Marseille Med, 53, 383.
- ↑ Lee SH, Lee ES, Yoon CH, Shin H, Lee CH. Collet-Sicard Syndrome With Hypoglossal Nerve Schwannoma: A Case Report. Ann Rehabil Med. 2017;41(6):1100-1104. doi:10.5535/arm.2017.41.6.1100
- ↑ Ordoñez-Granja J, Rivera Velazquez JE, Martinez Albarrán LA, Castillo-Rangel C. Glossopharyngeal schwannoma: Clinical case report. Schwannoma del glosofaríngeo: reporte de caso clínico. Neurocirugia (Astur : Engl Ed). 2020;31(2):93-97. doi:10.1016/j.neucir.2019.05.003
- ↑ Villatoro R, Romero C, Rueda A. Collet-Sicard syndrome as an initial presentation of prostate cancer: a case report. J Med Case Rep. 2011;5:315. Published 2011 Jul 14. doi:10.1186/1752-1947-5-315
- ↑ Al-Shabibi, T., Hamdi, H., Balaha, A., Ghoraba, Y., & Kaya, J. M. (2021). Delayed Collet-Sicard syndrome after internal carotid dissection and Jefferson fracture. Case report and Review of Literature. Surgical Neurology International, 12.