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Case report
Dysphagia, dysphonia and a deviated tongue: diagnosing Collet-Sicard syndrome
  1. Jennifer Evan1,2,
  2. Michelle Johansen2 and
  3. Lee Michael Akst3
  1. 1Neurology, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
  2. 2Neurology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3Otolaryngology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Dr Jennifer Evan; Jennifer.r.evan{at}gmail.com

Abstract

A healthy middle-aged man presents with symptoms of dysphagia and dysphonia following an upper respiratory infection, and is diagnosed and treated for complications of pharyngitis. He presents for evaluation at a tertiary care hospital after symptoms fail to resolve, with the final diagnosis being a carotid artery dissection with compressing pseudoaneurysm. This patient’s constellation of symptoms and physical examination findings are consistent with Collet-Sicard syndrome, a rare disorder caused by cranial nerve compression at the skull base. Understanding the morbidity of missing, or delaying, a diagnosis of carotid artery pathology, such as Collet-Sicard syndrome, underscores the importance of an accurate diagnosis. A review of cranial nerve anatomy, surrounding structures and potential mechanism of injury to the carotid artery are emphasised as key learning points.

  • cranial nerves
  • neuroimaging
  • interventional radiology

https://doi.org/10.1136/bcr-2021-243154

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    Footnotes

    • Contributors JE was involved in design of the work and drafting the manuscript, revision for and acquisition of intellectual content, and interpreting results of the clinical workup. MJ was involved in design of the work and significant interpretation of the results, clinical management of the patient, substantial revision of the manuscript and revision for and contribution to intellectual content. LMA was involved in interpretation of results, contribution to intellectual content of the manuscript, clinical management of the patient case, and revision of the manuscript. All authors agree to be responsible for all aspects of the work including accuracy of reported information. All authors have approved the final submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.