Horner's Syndrome Flashcards
What is Horner’s syndrome?
It is defined as a condition in which there a lesion to the sympathetic chain supplying the eye
What three eye structures are innervated by the sympathetic nerve system?
Dilator pupillae
Superior tarsal muscle
Sweat glands
What is the function of the dilator papillae?
Pupil dilatation
What is the function of the superior tarsal muscle?
Elevation of the upper eyelid
What are the three classifications of Horner’s syndrome?
First Order Horner’s Syndrome
Second Order Horner’s Syndrome
Third Order Horner’s Syndrome
Which clinical feature can be used to differentiate between the classifications?
Anhidrosis
What is another term for first order Horner’s syndrome?
Central Horner’s syndrome
What is first order Horner’s syndrome?
It involves a lesion to the first order neurone - which spans from the hypothalamus to the T1 spinal cord segment
In first order Horner’s syndrome, which areas of the body are affected by anhidrosis?
Face
Arm
Trunk
What are the four causes of first order Horner’s syndrome?
Stroke
Multiple Sclerosis
Brain Tumour
Encephalitis
Which stroke syndrome is commonly associated with first order Horner’s syndrome?
Wallenberg’s syndrome
What artery is affected in Wallenberg’s syndrome?
The posterior inferior cerebellar artery
What are the five clinical features associated with Wallengerg’s syndrome?
Horner’s features
Ipsilateral ataxia
Dysphagia
Hoarseness
Reduced gag reflex
What is another term for second order Horner’s syndrome?
Pre-ganglionic Horner’s syndrome
What is second order Horner’s syndrome?
It involves a lesion to the second order neurone – which spans from the hypothalamus to the superior cervical ganglion, via the cervical sympathetic