Raeder's paratrigeminal neuralgia secondary to internal carotid artery dissection mimicking trigeminal autonomic...

Raeder's paratrigeminal neuralgia is a rare clinical syndrome characterized by ipsilateral periorbital pain, partial Horner syndrome (ptosis and miosis without anhidrosis), and sensory disturbances in the ophthalmic division (V1) of the trigeminal nerve¹. The syndrome results from involvement of sympathetic fibers traveling along the internal carotid artery (ICA), often in association with vascular or parasellar pathologies². Among its etiologies, ICA dissection is particularly important, as it may present with unilateral headache and cranial autonomic features that closely mimic trigeminal autonomic cephalalgias (TACs)^2,3. This overlap may lead to misdiagnosis and delay in the identification of potentially serious vascular conditions⁴. Recognition of distinguishing clinical features is therefore critical.