Horner's Syndrome Flashcards
what are the features of horner’s syndrome?
- miosis
- ptosis
- enophthalmos
- anhidrosis
what is miosis?
small pupil
what is ptosis?
dropped eyelid
what is enophthalmos?
sunken eye
what is anhidrosis?
loss of sweating on one side
what is the pathophysiology of horner’s syndrome?
due to an interruption of the sympathetic nerve supply to the eye
how are the causes of horner’s syndrome classified?
- pre-ganglion
- post-ganglion
- central
what sign is seen in congential horner’s?
heterochromia (difference in iris)
how can you use to confirm the diagnosis of horner’s syndrome?
apraclonidine drops
(alpha-adrenergic agonist)
what do apraclonidine drops do?
causes pupillary dilation in horner’s syndrome due to denervation supersensitivity
BUT
produces mild pupillary constriction in the normal pupil by down-regulating the norepinephrine release at the synaptic cleft
what pattern of anhidrosis is in central lesions?
anhidrosis of the face, arm and trunk
what pattern of anhidrosis is in pre-ganglionic lesions?
anhidrosis of the face
what pattern of anhidrosis is in post-ganglionic lesions?
no anhidrosis
name the causes of central lesion horner’s syndrome?
S
* stroke
* syringomyelia
* multiple sclerosis
* tumour encephalitis
name the causes of pre-ganglionic lesion horner’s syndrome?
T
* pancoast’s tumour
* tyroidectomy
* trauma
* cervical rib
