背景:面部和颈椎疼痛是神经内科咨询的常见原因,可能是由于多种病理过程引起的。这些包括鹰综合征(ES),一种非常罕见的实体,其起源归因于茎突韧带的钙化或颞叶茎突的伸长。我们介绍了一系列五名诊断为ES的患者。
方法:我们描述了5名患者的人口统计学和临床特征以及对治疗的反应,这些患者参加了2家三级医院的头痛病房,其症状与Eagle综合征相符。
结果:患者为3名男性和2名女性,年龄在24至51岁之间,表现为沉闷,剧烈的疼痛,主要在内耳和同侧扁桃体窝。所有患者都有慢性,颞区持续疼痛,吞咽引发的恶化。先前有四名患者咨询了耳鼻咽喉科的几位专家;其中一位因疑似咽鼓管炎症而被处方抗生素。在所有情况下,扁桃体窝的触诊疼痛。计算机断层扫描显示3例患者的茎突伸长和/或茎突韧带钙化。四名患者通过神经调节疗法改善(度洛西汀,加巴喷丁,普瑞巴林),只有一个需要手术切除茎突。
结论:鹰综合征是一种罕见且可能未被诊断的颅面疼痛原因。我们提出了5个新病例,这些病例既体现了该实体的症状,也体现了其潜在的治疗方法。
BACKGROUND: Orofacial and cervical pain are a frequent reason for neurology consultations and may be due to multiple pathological processes. These include Eagle syndrome (ES), a very rare entity whose origin is attributed to calcification of the stylohyoid ligament or elongation of the temporal styloid process. We present a series of five patients diagnosed with ES.
METHODS: We describe the demographic and clinical characteristics and response to treatment of 5 patients who attended the headache units of 2 tertiary hospitals for symptoms compatible with Eagle syndrome.
RESULTS: The patients were 3 men and 2 women aged between 24 and 51, presenting dull, intense pain, predominantly in the inner ear and the ipsilateral tonsillar fossa. All patients had chronic, continuous pain in the temporal region, with exacerbations triggered by swallowing. Four patients had previously consulted several specialists at otorhinolaryngology departments; one had been prescribed antibiotics for suspected Eustachian tube inflammation. In all cases, the palpation of the tonsillar fossa was painful. Computed tomography scans revealed an elongation of the styloid process and/or calcification of the stylohyoid ligament in 3 patients. Four patients improved with neuromodulatory therapy (duloxetine, gabapentin, pregabalin) and only one required surgical excision of the styloid process.
CONCLUSIONS: Eagle syndrome is a rare and possibly underdiagnosed cause of craniofacial pain. We present 5 new cases that exemplify both the symptoms and the potential treatments of this entity.