PDF(Pubmed)
Abstract：
Combined deficit of the four lower cranial nerves (CN IX, X, XI, and XII) was originally described by French physicians Collet (1915) and Sicard (1917) during World War I. To date though, this rare neurological clinical picture lacks systematic evidence regarding its epidemiology, clinical presentation, treatment strategies, and outcome. We conducted a systematic review and meta-analysis concerning Collet-Sicard syndrome (CSS) on Medline database in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research yielded 84 articles among which 73 individual case reports were eventually retained. Mean age was 53.7 (± 16) years old and the male-to-female ratio was 1.8/1. CSS was firstly caused by tumors (38.4%), following by vascular etiologies (28.8%), trauma (16.4%), and infection (6.8%), among others. Temporary enteral nutrition was required for 17 patients (23.3%). The four CN presented significant chances of complete or partial recovery: 52.1% for CN IX ( p < 0.001), 46.6% for CN X and CN XII ( p < 0.001), and 39.7% for CN XI ( p = 0.002). Tumoral causes presented significantly lower chances of favorable CN recovery (7.1%) compared to infection (60%), vascular (52.4%), and trauma (41.7%) ( p < 0.001). Older age (> 53 years old) was not associated with a dismal CN prognostic ( p = 0.763). Most patients (71.2%) presented a favorable outcome (Glasgow Outcome Scale score ≥ 4). All the patients who died (6.8%) suffered from skull base tumors. CSS is a rare condition requiring prompt clinical and radiologic diagnostic and multidisciplinary management. Vascular or infectious-related CSS seem to present a rather good prognostic, closely followed by trauma, whereas tumoral-related CSS seem to suffer from a more dismal prognostic.
摘要：
四个下颅神经的联合缺陷（CNIX，X,XI,和XII）最初是由法国医生Collet（1915）和Sicard（1917）在第一次世界大战期间描述的。这种罕见的神经系统临床表现缺乏关于其流行病学的系统证据，临床表现,治疗策略,和结果。我们根据系统评价和荟萃分析指南的首选报告项目，在Medline数据库上对Collet-Sicard综合征（CSS）进行了系统评价和荟萃分析。该研究共发表了84篇文章，其中最终保留了73份个案报告。平均年龄为53.7（±16）岁，男女比例为1.8/1。CSS首先由肿瘤引起（38.4%），其次是血管病因（28.8%），外伤(16.4%),和感染(6.8%)，在其他人中。17例患者需要临时肠内营养（23.3％）。四个CN显示出完全或部分恢复的重要机会：CNIX为52.1％（p<0.001），CNX和CNXII的46.6%(p<0.001)，CNXI为39.7%（p=0.002）。与感染（60％）相比，肿瘤原因显示出良好的CN恢复（7.1％）的机会显着降低，血管（52.4%），和创伤（41.7％）（p<0.001）。年龄较大（>53岁）与CN预后不佳无关（p=0.763）。大多数患者（71.2％）表现出良好的结果（格拉斯哥预后量表评分≥4）。所有死亡患者（6.8%）均患有颅底肿瘤。CSS是一种罕见的疾病，需要及时的临床和放射学诊断以及多学科管理。血管或感染相关的CSS似乎表现出相当好的预后，紧随其后的是创伤，而与肿瘤相关的CSS似乎患有更令人沮丧的预后。
