Lyme disease associated with postganglionic Horner syndrome and Raeder paratrigeminal neuralgia. 2007

Marjorie A Murphy, and Erica M Szabados, and Jennifer A Mitty
Department of Ophthalmology, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island 02903, USA. margiemurphy@cox.net

A 55-year-old woman developed severe unilateral headaches, periocular numbness, and Horner syndrome after presenting with symptoms consistent with Lyme disease. The combination of Horner syndrome and periocular headache and numbness constituted a diagnosis of Raeder paratrigeminal neuralgia. Although the headaches resolved with antibiotic treatment, the Horner syndrome persisted for at least 1 year. This case expands the spectrum of neurologic manifestations of Lyme disease to include postganglionic Horner syndrome as well as Raeder paratrigeminal neuralgia.

UI MeSH Term Description Entries
D008193 Lyme Disease An infectious disease caused by a spirochete, BORRELIA BURGDORFERI, which is transmitted chiefly by Ixodes dammini (see IXODES) and pacificus ticks in the United States and Ixodes ricinis (see IXODES) in Europe. It is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. The disease was formerly known as Lyme arthritis and first discovered at Old Lyme, Connecticut. Lyme Borreliosis,B. burgdorferi Infection,Borrelia burgdorferi Infection,Lyme Arthritis,Arthritis, Lyme,B. burgdorferi Infections,Borrelia burgdorferi Infections,Borreliosis, Lyme,Disease, Lyme
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006732 Horner Syndrome A syndrome associated with defective sympathetic innervation to one side of the face, including the eye. Clinical features include MIOSIS; mild BLEPHAROPTOSIS; and hemifacial ANHIDROSIS (decreased sweating)(see HYPOHIDROSIS). Lesions of the BRAIN STEM; cervical SPINAL CORD; first thoracic nerve root; apex of the LUNG; CAROTID ARTERY; CAVERNOUS SINUS; and apex of the ORBIT may cause this condition. (From Miller et al., Clinical Neuro-Ophthalmology, 4th ed, pp500-11) Bernard Syndrome,Horner's Syndrome,Miosis, Innervational Defect,Oculosympathetic Syndrome,Bernard's Syndrome,Claude Bernard-Horner Syndrome,Horner Syndrome, Acquired,Horner Syndrome, Central,Horner's Syndrome, Pupil,Ophthalmoplegia, Sympathetic Ocular,Ptosis Sympathetic,Sympathetic Ocular-Ophthalmoplegia,Acquired Horner Syndrome,Bernard Syndromes,Bernards Syndrome,Central Horner Syndrome,Claude Bernard Horner Syndrome,Horner Syndrome, Pupil,Horners Syndrome,Horners Syndrome, Pupil,Ocular Ophthalmoplegia, Sympathetic,Ocular Ophthalmoplegias, Sympathetic,Ocular-Ophthalmoplegia, Sympathetic,Ocular-Ophthalmoplegias, Sympathetic,Oculosympathetic Syndromes,Ophthalmoplegias, Sympathetic Ocular,Pupil Horner's Syndrome,Sympathetic Ocular Ophthalmoplegia,Sympathetic Ocular Ophthalmoplegias,Sympathetic Ocular-Ophthalmoplegias,Syndrome, Acquired Horner,Syndrome, Bernard,Syndrome, Bernard's,Syndrome, Central Horner,Syndrome, Claude Bernard-Horner,Syndrome, Horner,Syndrome, Horner's,Syndrome, Oculosympathetic,Syndrome, Pupil Horner's,Syndromes, Bernard,Syndromes, Oculosympathetic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014277 Trigeminal Neuralgia A syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the TRIGEMINAL NERVE. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. Associated conditions include MULTIPLE SCLEROSIS, vascular anomalies, ANEURYSMS, and neoplasms. (Adams et al., Principles of Neurology, 6th ed, p187) Tic Doloureux,Tic Douloureux,Epileptiform Neuralgia,Fothergill Disease,Secondary Trigeminal Neuralgia,Trifacial Neuralgia,Trigeminal Neuralgia, Idiopathic,Trigeminal Neuralgia, Secondary,Disease, Fothergill,Epileptiform Neuralgias,Idiopathic Trigeminal Neuralgia,Idiopathic Trigeminal Neuralgias,Neuralgia, Epileptiform,Neuralgia, Idiopathic Trigeminal,Neuralgia, Secondary Trigeminal,Neuralgia, Trifacial,Neuralgia, Trigeminal,Secondary Trigeminal Neuralgias,Trifacial Neuralgias,Trigeminal Neuralgias

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