DefinePK

Abstract

INTRODUCTION


Painful carotid sinus is a common condition which is rarely recognized and often overlooked. The pain is localised in the area of the common carotid artery and at the level of the carotid bulb. The aetiology is usually not known and different causes such as inflammation, tumours around the artery or lymphadenitis nearby have been blamed for it. This is a benign condition, gives rise to no significant lesion of the artery and has a dramatic response to simple analgesics or a combination of simple analgesics and steroids. Fay1 was the first to describe this condition followed by Hilger2 who described it as “Carotid Pain” due to an imbalance of the autonomic nervous system of the carotid tree resulting in Angiospasm and Oedema but no inflammation. Lovshin3 called it “Vascular Neck Pain”, attributed it to an autonomic dysfunction, and treated his patients with a combination therapy of analgesics, psychotherapy, tranquilizers and ergotamine pre­parations. Saunders mentioned the possibility of a viral aetiology and called it carotid arteritis. He proposed a corticosteroid therapy which was the only effective treatment in his series. Chiossone and Ouiroga4 concluded it to be a viral infection which responded well to steroids with or without analgesics. More recently a Hypersensitive Caro­tid Sinus Syndrome has been described by Gang Elis et al5 characterised by attacks of Synocope but the carotid bulb is neither painful nor tender. It is usually found in patients suffering from ischaemic heart disease.