Neuroanatomy of bernardhorner syndrome and more about the. Horner syndrome is related to sympathetic paresis of the eye. It is considered as a syndrome for it includes several or a collection of symptoms. Horner s syndrome, also known as oculosympathetic paresis, is a combination of symptoms that arises when a group of nerves known as the sympathetic trunk is damaged. The underlying causes of horner s syndrome vary greatly and may include a tumor, stroke, injury. The condition is characterized by the sinking of ones eyeballs into the orbital cavity and. The symptoms generally include a sunken in eye enophthalmia with a small pupil miosis, a droopy upper eyelid ptosis and a prominent third eyelid. Pdf horner syndrome is an uncommon but important clinical entity, representing interruption of the sympathetic pathway to the eye and face. Birth trauma was the most common identifiable cause four patients. We present two cases of thyroid microcarcinoma who presented with horners syndrome on. Horners syndrome resulting from a cervical spinal cord injury at c4 would be a consequence of the interruption of descending sympathetic fibers. If horner syndrome is likely, magnetic resonance imaging mri or computed tomography ct of the brain, spinal cord, chest, or neck is done to look for tumors and other serious disorders that may be disrupting nerve fibers connecting the brain and the eye.
Horner syndrome horners syndrome or oculosympathetic paresis results from an interruption of the sympathetic nerve supply to the eye and is characterized by the classic triad of miosis ie, constricted pupil, partial ptosis, and loss of hemifacial sweating ie, anhidrosis, as well as enophthalmos sinking of the eyeball into the bony cavity that protects the eye. Also called oculosympathetic paresis, a horner syndrome can be produced by a lesion anywhere along the sympathetic pathway that supplies the head, eye, and neck. Horner syndrome classically presents as an ipsilateral enophthalmos, blepharoptosis, pupillary miosis and facial anhydrosis due to disruption at some point of the oculosympathetic pathway ptosis is due to interruption of the sympathetic motor innervation of the superior tarsal muscle which is a small muscle composed of smooth muscle fibers intimately associated with the. This condition results from lesions that interrupt the sympathetic nervous supply to the head, eye, and neck. Horners syndrome is not uncommon and occurs in dogs, cats, horses and many other species. Horners syndrome is usually acquired as a result of disease, but may also be congenital inborn, associated with heterochromatic iris or iatrogenic caused by medical treatment. Horner syndrome can be a sign of a serious health risk such as nerve damage. Horners syndrome is a rare condition characterized by miosis constriction of the pupil, ptosis drooping of the upper eyelid, and anhidrosis absence of sweating of the face. Horners syndrome is a rare condition characterized by miosis constriction of the pupil, ptosis drooping of the upper eyelid, and anhidrosis absence of. The signs and symptoms occur on the same side ipsilateral as it is a lesion of the sympathetic trunk. Horner syndrome hs is a neurological disorder characterized by a symptom triad of miosis an abnormally small pupil, partial ptosis drooping of the upper eyelid, and facial anhidrosis absence of sweating. What are the treatment options for horner syndrome. It can cause drooping eyelid, small pupil, and decreased sweating on the affected side of the face.
In some cases surgical removal of the lesion or growth may be. Horners syndrome is characterized by certain facial asymmetries, mainly involving the eye. Horner syndrome is a rare condition that affects the nerves to the eye and face. It may also have a droopy upper lid andor an elevated lower lid, and have a lighter colored iris than the other eye. As you know, horners syndrome causes ptosis a droopy eyelid, miosis a constricted pupil and anhidrosis loss of sweating on one side of the face caused from interruption of function of a nerve pathway. Firstorder neurons are located in the posterolateral hypothalamus, and from there, sympathetic fibers pass through the lateral brain stem and extend to the ciliospinal center of budge and waller in the intermediolateral gray column of the spinal cord at c8t1 figure 2. Does horners syndrome in infancy require investigation. Horners syndrome is an autonomic disorder resulting from an interruption of the oculosympathetic nerve pathway between the. Horners syndrome and weakness of upper limb after epidural anaesthesia for caesarean section. A central horner syndrome caused by damage to any of. It is characterized by miosis a constricted pupil, partial ptosis a weak, droopy eyelid, apparent. Horner s syndrome is a rare condition characterized by miosis constriction of the pupil, ptosis drooping of the upper eyelid, and anhidrosis absence of sweating of the face.
Horners syndrome occurs when theres damage along the oculosympathetic pathway. It is named after johann friedrich hornerthe swiss ophthalmologist who first described the syndrome senrromu it is characterized by miosis a constricted pupilpartial ptosis a weak, droopy eyelidapparent anhydrosis. Horners syndrome also called oculosympathetic paresis, or horner. The underlying causes of horners syndrome vary greatly and may include a tumor, stroke, injury. Aims to evaluate whether isolated horners syndrome presenting in the first year of life warrants investigation. Horners syndrome secondary to chest tube placement. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6. Horner syndrome may result from any one of a variety of factors, including carotid artery dissection.
Horner syndrome is a classic neurologic syndrome whose signs include miosis, ptosis, and anhidrosis. Horners syndrome genetic and rare diseases information. Horner syndrome and its symptoms result from damage to part of the sympathetic nervous system, which can arise from a number of causes. Horner syndrome hs, caused by an interruption in the oculosympathetic pathway, is characterised by myosis, ipsilateral blepharoptosis, enophthalmos, facial anhydrosis, and vascular dilation of the lateral part of the face. Horners syndrome is a medical condition that is considered rare and basically affects a persons eye and face, specifically the persons nervous system. Selective mr imaging approach for evaluation of patients with horners syndrome kathleen b. Horner syndrome consists of unilateral ptosis, an ipsilateral miotic but. Acute postpartum horners syndrome due to epidural anesthesia. Introduction the term horner syndrome is commonly used in english speaking countries, whereas the term bernardhorner syndrome is common in france horner syndrome horners syndrome results from an interruption of the sympathetic nerve supply to the eye. Waynehouser,md \sb\wedescribe five patientswith angio graphicfeatures of dissecting aneurysm of the cervical portion of the internal ca rotid artery who were seen initially with unilateral headaches and ipsilateralocu losympathetic paresis. Horner syndrome results from interruption of the oculosympathetic path way and is usually associated with unique clinical features classified into. If a postganglionic lesion is present peripheral horner syndrome, the pupil of the affected eye dilates much more than that of the unaffected eye because the iris dilator muscle of the affected eye has lost its sympathetic innervation and has developed adrenergic.
Horners syndrome is a rare syndrome that is based upon findings that are due to an alteration in the sympathetic neuropathway. Horners syndrome, also known as oculosympathetic paresis, is a combination of symptoms that arises when a group of nerves known as the sympathetic trunk is damaged. Summary edit description horners syndrome and autonomic innervation of the eye. These nerves control involuntary functions, such as dilation and. Horners syndrome in dogs symptoms, causes, diagnosis. Facial paralysis 410 and laryngeal hemiplegia 210, which are not direct features of horners syndrome, were also observed. Introduction the term horner syndrome is commonly used in english speaking countries, whereas the term bernard horner syndrome is common in france horner syndrome horners syndrome results from an interruption of the sympathetic nerve supply to the eye. Horner syndrome brain, spinal cord, and nerve disorders. Horner syndrome knowledge for medical students and. Horners syndrome symptoms, causes, treatment, pictures. Horners syndrome nord national organization for rare.
Once a thorough evaluation on the cause of horners syndrome has been performed, ptosis repair is an option. Theres no specific treatment for horner syndrome, but treatment for the underlying cause may restore normal nerve function. Horner syndrome free download as powerpoint presentation. Horners syndrome, also known as oculosympathetic palsy or bernardhorner syndrome, is a relatively rare condition that affects the eyes and part of the face. The condition sometimes results from an injury to the nerve but it can also be present from birth.
Generally cases of horners syndrome resolve themselves. Treatment of superior sulcus tumor pancoast tumor surg clin north. The affected eye will have an abnormally small pupil. Horners syndrome is a rare condition affecting the nerves to the eye and face. Approximately 60% of cases studied are from known causes and the other 40% are idiopathic 1. Apraclonidine is a weak alphaadrenergic agonist that minimally dilates the pupil of a normal eye. Damage to the firstorder neuron is caused by a spinal cord lesions above level t1 some causes include a stroke, tumors, or syringomyelia.
Neuroimaging strategies for three types of horner syndrome. Horners syndrome is a diagnosis by exclusion where all other possible causes like trauma, tumours etc are ruled out before a diagnosis is made. Horner syndrome is a rare condition characterized by three primary symptoms. Results in 16 patients 70% no cause was identified. Horner syndrome is the result of another medical problem, such as a stroke, tumor or spinal cord injury. There are two major divisions within your nervous system. Also called oculosympathetic paresis, a horner syndrome can be produced by a lesion anywhere along the sympathetic pathway that supplies the. To assess the usefulness of mr in the ealuation of patients with horners syndrome.
Horners syndrome usually results from a lesion to the sympathetic pathways that supply the head and neck region. Causes range from benign to serious, requiring a methodologic approach to. Successful radical treatment of these cancers resulted in complete resolution of the syndrome and diseasefree survival at 18 months. Full text get a printable copy pdf file of the complete article 674k, or click on a page image below to browse page by page. It can have many different symptoms, such as small pupils or droopy eyelids.
Causes horner syndrome can be caused by any interruption in a set of nerve fibers that start in the part of the brain called the hypothalamus and travel to the face and eyes. Selective mr imaging approach for evaluation of patients. It occurs due to a disruption of the pathway of the sympathetic nerves that connect the brain stem to the eyes and face. Horners syndromebernards syndrome what exactly is it. The history, mechanism and aetiology of horners syndrome is presented and the pharma cology of the pupil. Horners syndrome is a rare complication after videoassisted thyroidectomy vat. The main and most common characteristics of this syndrome are ptosis of the. Horners syndrome genetic and rare diseases information center.
Treatment depends on the etiology of horners syndrome. Pancoast syndrome clinical presentation shoulder and arm pain 90% in one series weakness of the muscles of the hand horner syndrome most commonly caused by extension ofapical lung tumors pancoast tumor atthe superior thoracic inlet invasion of the brachial plexus, vertebrae,subclavian vessels and sympathetic ganglia. If the svg file only contains raster graphics fakesvg is supposed to be used. Spontaneous internal carotid dissection, hemicrania, and. Horners syndrome results from loss of sympathetic innervation to the eye and is characterized by miosis, ptosis, enophthalmos, and protrusion of the third eyelid figure 2736. Horners syndrome, the triad of miosis, ptosis, and enophthalmos, is a common complication of regional blockade of the brachial plexus, following disruption of sympathetic nerve input from the cervical sympathetic ganglia 1 a. Our general interest enewsletter keeps you up to date on a wide variety of health topics. Horners syndrome is a mix of symptoms that are caused when theres a disruption in the path of the nerves that run from the brain to the face.
A 15yearold female patient presented with solitary solid and large nodule in the right thyroid lobe. Horners syndrome and vocal cord paralysis as a complication of percutaneous internal jugular vein catheterisation in adults. The causes of horners syndrome varies with the age of the patient and site of the lesion. Horners syndrome in veterinary medicine, signs can include partial closure of the third eyelid, or nictitating membrane. The treatment of horner syndrome depends on the location and cause of the lesion or tumor. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Horner syndrome causes problems on one side of your face when the nerves there are damaged. The significance of horners syndrome lies in the underlying diseases that cause this syndrome, rather than a clinical disease by itself. Horner syndrome consists of unilateral ptosis, an ipsilateral miotic but normally reactive pupil, and in some cases, ipsilateral facial anhidrosis, all resulting from damage to the ipsilateral oculosympathetic pathway.