Horners syndrome

Question 1

Clinical features

Answer 1

pupil constriction
ptosis
enophthalmos (sunken eye)
anhidrosis (loss of sweating)

Question 2

What is Horner’s syndrome?

Answer 2

Lesion in sympathetic chain

Question 3

What structures in the eye have sympathetic supply?

Answer 3

Dilator pupillae

Superior tarsal (or Muller’s) muscle: aids in elevating the upper eyelid

Sweat glands

Question 4

Sign of congenital Horner’s syndrome

Answer 4

heterochromia (difference in iris colour)

Question 5

If a suspected Horner’s syndrome is causing anhidrosis of the face, arm and trunk, where is the lesion?

Answer 5

Central

• Stroke
• Syringomyelia
• MS
• Tumour
• Encephalitis

Question 6

If a suspected Horner’s syndrome causes anhidrosis of the face only, where is the lesion likely to be?

Answer 6

Pre-ganglionic Lesion:

• Pancoast’s tumour
• Thyroidectomy
• Trauma
• Cervical rib

Question 7

If a suspected Horner’s syndrome causes no anhidrosis, where is the lesion likely to be?

Answer 7

Post ganglionic Lesion:

• Carotid artery dissection
• Carotid aneurysm
• Cavernous sinus thrombosis
• Cluster headache