Horner's syndrome Flashcards
definition of horner’s
Horner syndrome (HS) is a neurological disorder characterized by a symptom triad of miosis (an abnormally small pupil), partial ptosis (drooping of the upper eyelid), and facial anhidrosis (absence of sweating)
aetiology of horner’s
interruption of the face’s sympathetic supply, eg at the brainstem (demyelination, vascular disease), cord (syringomyelia), T1 root (brachial plexus lesion, neurofibromatosis) thoracic outlet (Pancoast’s tumour), or on the sympathetic’s trip on the internal carotid artery (dissection, occlusion) into the skull , and orbit.
causes of horner’s
- Posterior inferior cerebellar artery or basilar artery occlusion
- Multiple sclerosis
- Cavernous sinus thrombosis
- Pancoast’s tumour
- Hypothalamic lesions
- Cervical adenopathy
- Mediastinal masses
- Pontine syringomyelia
- Klumpke’s palsy
- Aortic aneurysm
brainstem stroke
carotid dissection
epidemiology of horner’s
rare
sx of horner’s
A triad of miosis (pupil constriction) partial ptosis (drooping upper eyelid) + apparent enophthalmos (sunken eye) anhidrosis (ipsilateral loss of sweating).
Unilateral facial anhydrosis may indicate a lesion proximal to the carotid plexus—if distal, the sudomotor (sudor= sweat) fibres will have separated, so sweating is intact.
migraines and cluster headaches
signs of horner’s
facial flushing due to vasodilation
enophthalmos
atrophy of arm and hand muscles
ix for horner’s
o Angiography of the head and neck (MRI or CT)- Carotid artery dissection, occurring for example after severe whiplash injuries of the neck or after prolonged neck extension. Angiography (MRA or CTA) is the gold standard test to exclude or detect carotid artery dissection.
o Chest XR/ct - Pancoast’s tumour, i.e. a lung tumour in the lung apex,
complications of horner’s
dizziness
problems seeing
neck pain or a headache that is sudden and severe
weak muscles or inability to control your muscle movements
