Collet-Sicard Syndrome

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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.

Disease Etiology

The etiology of Collet-Sicard syndrome can be divided into neoplastic and non-neoplastic causes:

Neoplastic

  • Jugular Paraganglioma
  • Meningioma
  • Schwannoma[3][4]
  • Metastatic Disease[5]

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.

Cranial Nerve Involvement in Skull Base Masses
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

  1. 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.
  2. Sicard, J. A. (1917). Syndrome du carrefour condylodechire posterieur (type pur de paralysie laryngee associee). Marseille Med, 53, 383.
  3. 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
  4. 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
  5. 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
  6. 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.