Cases of internal carotid artery dissection resulting in palsies of the cranial nerves are now well known.1 The nerve most often involved is the hypoglossal nerve, either individually or in association with other lower cranial nerves.1 2 We report on a patient with glossopharyngeal nerve (IXth) damage without involvement of other lower cranial nerves, resulting from a limited internal carotid artery dissection, a syndrome not previously described.

A 54 year old man suddenly developed a left periorbital headache without cervicalgia, and a left sided Horner’s syndrome. On subsequent days, he developed dysgeusia and a left inferior sore throat in swallowing. No recent relevant cervical or cranial trauma was reported. However, the patient had been in the habit of performing lateral and flexion-extension movements of the neck every morning, and had cut branches of a tree three days before the initial symptoms. On clinical examination, left-sided Horner’s syndrome and dysgeusia, with involvement of the posterior third of the left hemitongue, were found. Protraction …