Jugular foramen syndrome, or Vernet’s syndrome is characterized by the paresis of 9th–11th (with or without 12th) cranial nerves together.
In contrast to the majority of classic brainstem syndromes, the interpretation of Schmidt’s syndrome (ipsilateral palsy of the IX, X, XI, and XII cranial nerves with contralateral hemiparesis) and Vernet’s syndrome (ipsilateral palsy of the IX, X, and XI nerves with contralateral hemiparesis) is controversial. They are sometimes addressed as crossed brainstem syndromes but also as syndromes due to multiple cranial nerve lesions without contralateral hemiparesis. In this study, the historic descriptions and recent publications about Schmidt’s and Vernet’s syndromes were reviewed and critically analysed. We conclude that historic descriptions and later publications describe exclusively patients with extracerebral lesions of multiple cranial nerves. “Central” syndromes of Schmidt and Vernet caused by brainstem lesion appear not to exist. An extremely extensive lesion explaining these hypothetical unilateral brainstem syndromes is theoretically possible but, however, was apparently never observed in any of the known unilateral brainstem diseases 1).
Symptoms of this syndrome are consequences of this paresis. As such, in an affected patient, you may find:
soft palate dropping
deviation of the uvula towards the normal side
loss of sensory function from the posterior 1/3 of the tongue
decrease in the parotid gland secretion
loss of gag reflex
sternocleidomastoid and trapezius muscles paresis.
A variety of neoplasms, vascular insults, infections, and trauma have been reported to cause JFS 2).
The causes of Vernet syndrome are primary tumors such as Glomus jugulare tumors (most frequently), meningioma, vestibular schwannoma, cerebellopontine angle metastases, inflammation such as meningitis and malignant otitis externa, and sarcoidosis, Guillain-Barre syndrome 3).
Obstruction of the jugular foramen due to bone diseases 7).
Varicella-zoster virus 8).
Internal jugular vein thrombosis 11).
After carotid endarterectomy 12).
Large mycotic aneurysm of the extracranial internal carotid artery after acute otitis media 13).
Systemic erythematous lupus 14).