Horners Syndrome

Question 1

What is Horner’s syndrome?

Answer 1

Disruption of the sympathetic nerves supplying the face resulting in a triad of: 
Partial Ptosis (ipsilateral)
Miosis (constricted pupil) 
Anhydrosis 
(+ enophthalmos)

Question 2

Explain the aetiology of Horner’s syndrome

Answer 2

Caused by disruption of the sympathetic nerves, often idiopathic

Question 3

List 7 causes of Horner’s syndrome

Answer 3

Strokes  
Multiple sclerosis  
Apical lung tumours  
Lymphadenopathy  
Basal skull tumours  
Carotid artery dissection 
Neck trauma

Question 4

Describe the epidemiology of Horner’s syndrome

Answer 4

RARE

Important sign that is associated with various diseases (most notably, Pancoast tumours)

Question 5

List 5 symptoms of Horner’s syndrome

Answer 5

Inability to open the eye fully on the affected side  
Loss of sweating on affected side  
Facial flushing  
Orbital pain/ headache  
Other symptoms based on CAUSE

Question 6

List 4 signs of Horner’s syndrome

Answer 6

Ptosis
Miosis
Anhydrosis
Enophthalmos

Question 7

What investigations are performed in Horner’s syndrome?

Answer 7

Based on determining underlying cause
CXR: apical lung tumour
CT/ MRI: cerebrovascular accidents
CT angiography: dissection

Question 8

How is Horner’s syndrome managed

Answer 8

Horner’s syndrome is a sign not a disease in itself

So tx depends on the cause (e.g. tx for carotid dissection is very different to management of apical lung tumours)

Question 9

What are the complications and prognosis in Horner’s syndrome?

Answer 9

Dependent on cause