Publicação
When Eagle Syndrome knocks on the cardiologist's door — regarding a clinical case study
| Resumo: | Eagle Syndrome (ES) is a rare disease caused by stylohyoid complex abnormalities, such as an elongated styloid process. Albeit frequently associated to cervical and orofacial pain, it can present with distinct symptomatology, triggered by neck movements that result in the compression of neurovascular structures, conditioning one of two described presentations: the classic one (stylohyoid syndrome) or the vascular one (stylocarotid syndrome). In this paper we describe the clinical case of a 33-year-old male with bilateral elongated styloid processes, presenting solely with recurrent syncope preceded by prodromic symptoms, triggered by neck extension and rotation. To our knowledge this is the first time that a case of ES has been described with this presentation, and in the field of cardiology. As in other published articles, where atypical ES is reported in different contexts, a multidisciplinary approach to this diagnostic hypothesis is recommended, with an emphasis on a detailed clinical history, considering that many patients often go through several doctor appointments before a diagnosis is made.We argue that this disease may be subjected to an underdiagnosis bias, and with this paper we aim to raise awareness for this often-under-recognized diagnostic hypothesis as a possibility for patients who still bear the diagnosis of syncope of unknown etiology. Stylohyoid complex anomalies can be overlooked as simple anatomic variants, not remarked at all, or undetectable, by lack of imaging studies of the cervical region. Hence, they could be neglected as a cause for symptoms other than classic orofacial pain and dysphagia, for which Eagle Syndrome is mostly known for. In such cases, thorough clinical history and cervical region examination might reveal a tendency for positioning of the head to influence symptom manifestation, leading to further studies to corroborate the diagnosis. |
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| Autores principais: | Jesus, Filipa Alexandra da Costa |
| Assunto: | síndrome estilocarotídeo síncope recorrente processo estilóide alongado síndrome de Eagle Eagle Syndrome stylocarotid syndrome recurrent syncope elongated styloid process |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade de Coimbra |
| Idioma: | inglês |
| Origem: | Estudo Geral - Universidade de Coimbra |
| Resumo: | Eagle Syndrome (ES) is a rare disease caused by stylohyoid complex abnormalities, such as an elongated styloid process. Albeit frequently associated to cervical and orofacial pain, it can present with distinct symptomatology, triggered by neck movements that result in the compression of neurovascular structures, conditioning one of two described presentations: the classic one (stylohyoid syndrome) or the vascular one (stylocarotid syndrome). In this paper we describe the clinical case of a 33-year-old male with bilateral elongated styloid processes, presenting solely with recurrent syncope preceded by prodromic symptoms, triggered by neck extension and rotation. To our knowledge this is the first time that a case of ES has been described with this presentation, and in the field of cardiology. As in other published articles, where atypical ES is reported in different contexts, a multidisciplinary approach to this diagnostic hypothesis is recommended, with an emphasis on a detailed clinical history, considering that many patients often go through several doctor appointments before a diagnosis is made.We argue that this disease may be subjected to an underdiagnosis bias, and with this paper we aim to raise awareness for this often-under-recognized diagnostic hypothesis as a possibility for patients who still bear the diagnosis of syncope of unknown etiology. Stylohyoid complex anomalies can be overlooked as simple anatomic variants, not remarked at all, or undetectable, by lack of imaging studies of the cervical region. Hence, they could be neglected as a cause for symptoms other than classic orofacial pain and dysphagia, for which Eagle Syndrome is mostly known for. In such cases, thorough clinical history and cervical region examination might reveal a tendency for positioning of the head to influence symptom manifestation, leading to further studies to corroborate the diagnosis. |
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