Villaret's syndrome: a report of two cases.

The syndrome resulting from lesions of the lower four cranial nerves (CN) and the cervical sympathetic chain is known as Villaret's syndrome. We report two cases of the syndrome and emphasize the localizing value of this constellation of signs. The second case is unusual because involvement of the cervical sympathetic chain produced sympathetic overactivity, instead of the usual sympathectomy effect. Increased sympathetic outflow expressed as pupillary dilation, widened palpebral fissure, and facial sweating (the Claude Bernard syndrome) usually occurs as an early manifestation of apical thoracic tumors and has not been previously associated with Villaret's syndrome.