Raeder's syndrome associated with internal carotid artery dilation and sinusitis

Raeder's syndrome consists of ipsilateral ptosis, miosis and facial pain with intact facial sweating. When not associated with other neurologic signs, the clinical course of this conditions is self-limited. Patients will have resolution of facial pain but persistence of miosis and ptosis. Treatment is symptomatic with arteriography reserved for those patients with protracted symptoms or atypical presentations. A case of Raeder's paratrigeminal syndrome is presented with abnormal dilation of the subcavernous portion of the internal carotid artery thought to be secondary to inflammation of the adjacent sphenoid sinus. Facial pain and the abnormal dilation of the carotid artery resolved, but miosis and ptosis persisted. Because of the therapeutic indication and prognostic value, an awareness of Raeder's syndrome is stressed when evaluating patients with facial pain or possible Horner's syndrome.