Horner's Syndrome

Question 1

What causes Horner’s?

Answer 1

Interruption of the sympathetic pathway (on internal carotid)

Question 2

Central (1st order) Causes of Horner’s?

Answer 2

Hypothalamus: stroke/tumour
Apical tumour= Pancoast tumour
Brainstem: Stroke/demyelination (MS)/Tumour
Spinal Cord: Trauma/Myelitis/Tumour/Demyelination

Question 3

Preganglionic (2nd order) causes of Horner’s?

Answer 3

Cervical Spine Disease
Brachial Plexus Injury
Subclavian Artery aneurysm
Pulmonary Apical lesion
Thyroid Tumour

Question 4

Postganglionic (3rd order) causes of Horner’s?

Answer 4

Superior cervical ganglion: Trauma/ Iatrogenic

Internal Carotid Artery: Dissection/ Aneurysm/ Arteritis

Question 5

Symptoms of Horner’s?

Answer 5

Unlateral Miosis- Pupil Constriction
Ptosis (partial) - Eyelid droop
Anhydrosis- Inability to sweat
Enophtalmus (apparent)- Sunken Eye