Eagle syndrome: Lights and shadows of an underestimated condition of multidisciplinar interest

Abstract

Eagle Syndrome (ES) is an often misdiagnosed syndrome due to its wide spectrum of signs and symptoms. Recent works have pointed out the relation between ES and some types of craniofacial pain often misdiagnosed with migraine or temporomandibular disorders. Moreover, the presence of Vascular ES as a cause of Carotid Artery Dissection in same cases of stroke as well as cause of intracranial venous hypertension resulting in migraine and other pains has been recently discussed. A multidisciplinary approach is mandatory to allow clinicians to better understand the pathophysiology and clinical main patterns of ES. The aim of the work is to perform a comprehensive review all the clinical patterns and available diagnostic tools to guide clinicians through lights and shadows of such an underestimated syndrome. Finally, a novel flow-chart for comprehensive diagnosis of ES is proposed, including “dynamic” imaging investigating the relationship between stiloyd processes and the neurovascular structures of the neck during head movements.

Keywords

• Eagle syndrome
• Carotid artery dissection
• Styloid process
• Idiopathic CCAD
• Craniofacial pain
• Intravascular ultrasound IVUS