Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Nov 18;16(11):e73920.
doi: 10.7759/cureus.73920. eCollection 2024 Nov.

Collet-Sicard Syndrome Secondary to Tuberculosis of the Base of the Skull: A Case Report

Siddhant Jain  1 , Ravi Talapa  1 , Nidhi Yadav  1 , Anjali Chanyal  1 , Kunal Saini  1
Affiliations
Case Reports

Collet-Sicard Syndrome Secondary to Tuberculosis of the Base of the Skull: A Case Report

Siddhant Jain et al. Cureus. .

Abstract

Collet-Sicard syndrome, resulting from the involvement of all four lower cranial nerves, is an extremely rare condition. This case report details a 69-year-old female patient who presented with classic signs and symptoms of lower cranial nerve palsies (IX, X, XI, and XII) and was subsequently diagnosed with Collet-Sicard syndrome secondary to tuberculosis at the base of the skull. A contrast-enhanced MRI of the neck revealed bone marrow edema in the clivus, occipital condyle, and C1 vertebra, along with diffuse surrounding soft tissue swelling and collection, findings consistent with tuberculosis. The patient was treated with antitubercular therapy and steroids, along with neuromuscular and vocal rehabilitation. She showed significant improvement two months after starting antitubercular therapy and steroids. Tubercular Collet-Sicard syndrome should be suspected in patients presenting with cranial nerve palsies, elevated erythrocyte sedimentation rate, and abnormal imaging, as early recognition and treatment can lead to successful recovery.

Keywords: collet-sicard syndrome; diabetes mellitus complication; jugular foramen syndrome; lower cranial nerve palsy; skull base tuberculosis; steroid therapy.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Contrast-enhanced MRI of the brain (T1-weighted) showing post-contrast enhancement of the clivus, and occipital condyles with adjacent peripherally enhancing collection.
The blue arrow points to the bone marrow edema in the clivus with diffuse surrounding soft tissue swelling.
Figure 2
Figure 2. Contrast-enhanced MRI of the brain (T1-weighted, sagittal section) showing post-contrast enhancement of the C1 vertebra with degenerative changes and surrounding soft tissue enhancement.
The blue arrow points to the degenerative changes in the C1 vertebra with surrounding soft tissue swelling and collection.
See this image and copyright information in PMC

References

    1. Brazis PW, Masdeu JC, Biller J. Localization in Clinical Neurology. Alphen aan den Rijn, Netherlands: Wolters Kluwer; 2017. Localization in Clinical Neurology.
    1. Delayed lower cranial nerve palsy (Collet-Sicard syndrome) after head injury. Kato M, Tanaka Y, Toyoda I, Ogura S, Yoshimura S, Iwama T. Injury Extra. 2006;37:104–108.
    1. Dysphagia and dysphonia in a patient with cancer. Schattner A, Mate A, Lahav G, Adi M. Am J Med Sci. 2009;338:236–237. - PubMed
    1. A case of Collet-Sicard syndrome associated with traumatic atlas fractures and congenital basilar invagination. Hsu HP, Chen ST, Chen CJ, Ro LS. J Neurol Neurosurg Psychiatry. 2004;75:782–784. - PMC - PubMed
    1. Collet Sicard syndrome as atypical presentation of neck fibrosarcoma: a case report. Petrović S, Grozdanović D, Kovačević P, Višnjić M, Petrović D. Bosn J Basic Med Sci. 2011;11:137–140. - PMC - PubMed

Publication types

LinkOut - more resources