Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Raeder's Paratrigeminal Neuralgia

Forum: Neurology Forum
Topic: Neuralgia


I am 37 years old and was diagnosed with Raeder's Paratrigeminal Neuralgia. I have constant headache pain ranging from moderate to severe, a slightly constricted right pupil and drooping eyelid (symptoms become more pronounced with increased pain), and get "sore" or "tender" spots on my scalp lasting for several days and varying in location. I have also been told I have "Horner's Syndrome." Are these the same? Two brain scans show a stroke (infarct) in the thalmus (can't recall which side).
I have yet to meet someone else diagnosed with this and am looking for information. I have had minor relief from elavil and zomig, but nothing too substantial. Currently the only thing that relieves the pain is vicodin and I'm worried about long term side effects.
________
Thanks for the questions. Raeder's Paratrigeminal Neuralgia is a relatively
uncommon neurologic disorder characterized by partial paralysis of some
external eye muscle (causing ptosis, or droopy eyelids), and also a
constriction (decrease in size) of the eye pupil on the same side. Because
of such symptoms, Raeder's can often be confused with Horner's syndrome,
which is caused by a partial/complete damage of sympathetic nerve fibers
that innervate the eyes. These fibers are necessary for proper eye
opening, and dilation of the pupils. In addition, the sympathetic fiber
are also necessary for proper function of sweat glands in the face.

In contrast to Horner's syndrome, Raeder's is thought to be a result of
irritation to the fifth cranial nerve, also called the Trigeminal nerve.
The syndrome has been associated with head trauma, hypertension, vasculitis,
migraine headaches, and lesions to the carotid arteries.

The thalamus is a major "relay station" of the sensations to the brain,
and a lesion of the thalamus, such as an infarct, can cause altered
perception to specific parts of the body, such as the face and the scalp.
However, it is less common for these altered sensations to have an
intermittent pattern such as the one you seem to be describing for your
"scalp aches".

If you would like to seek specialized neurological evaluation, appointments
to the Headache Center at the Cleveland Clinic can be made by contacting
1-800-CCF-CARE.

This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.
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