Pericarotid syndrome

Six patients with a syndrome characterized by oculosympathetic paralysis, ipsilateral head pain, and anhidrosis over the forehead with otherwise intact facial sweating are described. Thirty-one similar cases have been collected from the literature which have been designated in the past as either 'paratrigeminal' or 'Reader's' syndrome. These cases, however, do not resemble very much the five original cases described by Reader nor is the location of oculosympathetic paralyis 'paratrigeminal'. Clinical evidence from a detailed study of these thirty-seven cases, animal and human experimental evidences, and observations from our own dissections are presented to establish the fact that the site of lesion of the oculosympathetic fibers in these patients is 'pericarotid' and not 'paratrigeminal'. This clinico-anatomical study also helps one to better understand the exact course taken by the oculosympathic fibers from the superior cervical ganglion to reach the various structures in the orbit. Probable pathogenesis and causative factors of this syndrome are also discussed.