Eagle Syndrome

Good morning everyone, I hope health is good, pain is low, and spirits are high. Well we had an uneventful but event packed night last night. Another trip to the ER with stroke like symptoms and yet they did nothing except declare I was OK and I should see my PCP right away. How did they gather this wisdom; from an echo that was over 1 year old and an EKG. The ER doc must be psychic or a know everything and right 100% of the time; arrogant twerp he was.

Anyhow, we got home last night and started doing more research from what we were already doing and we limited it down to Eagle Syndrome. Let me tell you interesting and shares some symptoms with CM/SM. Well from our research it looks like we have a winner with Eagle Syndrome. It seems to fit like my symptoms did with CM/SM but it looks like more rounds of educating the doctor yet again because of its rarity. Joy O Joy let me tell you. Anyhow I joined Ben's Friends Living with Eagle - a sister site to us and I am hoping some people there can shed some light on this for me.

My question for us here has anyone been diagnosed with Eagle? Can anyone shed some light on it; we done some research but like with everything the more knowledge the better. Has anyone heard of or know someone with both diagnoses Eagle and CM/SM? Any info would be great as we compile more and more ( we have my sister in law helping us do some research and her engineering background is great due to the attention to detail she has.).

Thanks in advance for help and support. I hope everyone has a great weekend. If you are recovering from decompression, may it be quick and without complications. May the medicine do its job and may you been pain free very soon. If you are having surgery soon - may the surgeon and their team be blessed with knowledge and patience; let their skill be unified and flawless while under their care. Maqy this lead you down the road to recovery and the beginning of a new life day by day.

Mike

Abby,

well it must be that time of year cause even after explaining to my PCP what happened last night and letting Chris explain and talk to them I can not get an appointment and doing research I counted 17 out of 26 symptoms. Looks like I might be going back to old PCP if he accepts the insurance insurance company says he does but with the phrase check with his office first. Head is spinning from all the research and haven't even scratched the surfaced. Yes it seems very possible. Will let you know the outcome/progress of this journey.

Abby said:

Mike,

You again, amazed me. I looked it up, never heard of it. But, think about it...... We are so complexed this is possibility for you. Thank you for posting this, I had it look it up. Some of the symptoms seem very familiar. I hope your doctors can get you diagnosed very soon. Hope you and the girls have a great weekend.

For those not sure what it is,

Eagle syndrome or styloid–carotid artery syndrome[1] is a rare condition where an elongated temporal styloid process (more than 30mm) is in conflict with the adjacent anatomical structures.

Two forms of eagle syndrome exists: The classic form and the vascular one

Symptoms

Patients with this syndrome tend to be between 30 and 50 years of age but it has been recorded in teenagers and in patients > 75 years old. It is more common in women with a male:female ratio ~ 1:2.

Patients with the classic "Eagle Syndrome" can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain, and otalgia.

In patients with the vascular form of "Eagle syndrome", the elongated styloid process is in contact with the extracranial internal carotid artery. This can cause a compression (while turning the head) or a dissection of the carotid artery causing a transient ischemic event or a stroke.

Given its anatomical position, Eagle Syndrome can elicit a wide variety of symptoms (patients may present with one, several or most of these conditions). Many of these symptoms are so general as to compel a careful differential diagnosis:

Wake up with mild to medium headaches most every morning • Migraines 3-4 times a week. • Throbbing Headache in base of neck up into skull and eye area. • Rest of neck and face throb. • Most days head and neck pain. • Discomfort from base of skull to ears. • Leaving head in flexed, down or rear position for too long may trigger a headache. • Nerve pain running down the neck shoulder and left arm to elbow, little and ring finger, numbness, tingling, achiness, and occasionally swelling. • Feeling of something catching on or behind something in neck. • Frequently discomfort may occur during yawning, stretching, and turning head. (This may cause severe pain. Severe burning pain in neck causes throat to spasm, from ear to mid neck.) • Feeling of hurt in back of throat. • Sore bruised throat, often upon waking. • Voice hoarseness, frequently daily. • Throbbing jaw, neck, face, palate and eyes, vision throbs, but with no pain. • Hot burning feeling base of inner ears. • Hear ringing/ buzzing/ blood rushing in ears. • Occasional Vertigo, room spinning, • LPR reflux. • Burning lungs, asthma like symptoms, coughing, hoarse voice and phlegm. • Difficult starting to swallow at times, getting food to go down, frequent choking. • Feels like something is protruding in right side of throat. • Food will sometimes get stuck in back of throat, or get in nasal/sinus when coughing. • Pain during opening mouth wide, yawning. • Frequent throat clearing. • Shooting eye pain, top inside corner of left eye. • Turning and flexing head and neck; limited range of motion in neck. Patient tends to turn from shoulders and waist.

Diagnosis

Diagnosis is suspected when a patient presents with the symptoms of the classic form of "eagle syndrome" e.g. unilateral neck pain, sore throat or tinnitus. On the exam, one can sometimes palpate the tip of the styloid process in the back of the throat. The diagnosis of the vascular type is more difficult and requires an expert opinion. One should have a high level of suspicion when neurological symptoms occurs upon head rotation. Symptoms tend to be worsened on bimanual palpation of the styloid through the tonsillar bed. They may be relieved by infiltration of lidocaine into the tonsillar bed. Because of the proximity of several large vascular structures in this area this procedure should not be considered to be risk free.

Imaging is important and is diagnostic. Visualizing the styloid process on a CT scan with 3D reconstruction is the suggested imaging technique.[2] The enlarged styloid may be visible on an orthopantogram or a lateral soft tissue X ray of the neck.

It is worth noting that the styloid may be enlarged (>30 millimeters in length) in 4% of the population and only a small minority (~4%) of people with enlarged styloids have symptoms.

Treatment

In both the classic and vascular form, the treatment is surgical.[3] A partial styloidectomy is the preferred approach. Repair of a damaged carotid artery is essential in order prevent further neurological complications.

Beeba,

Haven't had those tests maybe and considering asking for them, but see what I told Abby about the doc, rather frustrated right now so going to med school seems like a good option if only the chiari brain wold remember any of the information. If I get to my old PCP i will ask him about those tests. I had some symptoms before the surgery; most of the symptoms are new except as you can see how some overlap with CM and to make matters even more confusing a couple months ago, I was in the hospital with what they called stroke like symptoms. my feelings were they were treating it like a a stroke, it acted like a stroke, and it looked like a stroke so it was a stoke but they could not find any evidence of a stroke...so stroke like symptoms - I say stroke cause I have had a few unexplainable TIA's in the past and reading the explanation that Abby posted makes a lot of sense.

What is this normal feeling you speak of - I do not recall of such a thing, does it really exist or is it some mythical thing like a unicorn. LOL - I couldn't help myself, I am looking for humor since the grief of the doc is so frustrating and setting off more symptoms today which as we know we do not need more problems than the ones that already exist.



Beeba said:

Uh oh!! Now I have it!! Lol I have to wonder if having the surgery with over flexible muscles,tendons and joints could certainly seem to stretch this out causing these symptoms. Michael have you had a flex/ext MRI? Rotational cat scan? My head basically sits on my back so of course this little research I did - I don't find it impossible. I have an appointment next week (can't get here soon enough) with a dr who does seem to take all these factors into consideration - I will certainly be asking about this theory. Thank heaven I never went to med school - gosh only knows what I would diagnose myself with!! But something's seem like people are reaching - this one actually seems very possible. Did you have these same symptoms before surgery or only after? I certainly understand it all just becomes a blur and it can be hard to remember what normal feels like. Kind of like the definition of "offensive" hard to put your finger on it but you know it when you see it.

Mike,
Please let us know how your journey is going…I still adore your humor!!!
Abby…your research is great…many thanks for posting all that fabulous info on Eagles.

Beeba…I think you should go back to school and get your MD…I am serious…you would be a fantastic doctor!