Horner's syndrome

 ICD9        = 337.9|

}} Horner's syndrome is a clinical syndromecaused by damage to the sympathetic nervous system.

Symptoms

It results in ptosis(drooping upper eyelid), miosis(constricted pupil), and occasionally enophthalmos(the impression that the eye is sunk in) and anhidrosis(decreased sweating) on one side of the face.

In children Horner's syndrome sometimes leads to a difference in eye color between the two eyes (heterochromia). This happens because a lack of sympathetic stimulation in childhood interferes with melaninpigmentation of the melanocytesin the superficial stroma of the iris.

History

It is named afterDr Johann Friedrich Horner (1831-1886), the Swissophthalmologistwho first described the syndrome in 1869. Several others had previously described cases, but "Horner's syndrome" is most prevalent. In France, Claude Bernardis also eponymised with the condition being called "syndrome Bernard-Horner".

Causes

Horner's syndrome is usually acquired but may also be congenital. Although most causes are relatively benign, Horner's syndrome may reflect serious pathology in the neck or chest (such as a Pancoast tumor) and hence requires workup.

Horner's Syndrome is due to a deficiency of sympatheticactivity. The site of lesion to the sympathetic outflow is on the ipsilateralside of the symptoms. The following are examples of conditions that cause the clinical appearance of Horner's Syndrome:

• First-order neuron disorder: Central lesions that involve the hypothalamospinal pathway(e.g. transection of the cervical spinal cord).
• Second-order neuron disorder: Preganglioniclesions (e.g. compression of the sympathetic chain by a lung tumor).
• Third-order neuron disorder: Postganglioniclesions at the level of the internal carotid artery (e.g. a tumor in the cavernous sinus).

Diagnosis

Three tests are useful in confirming the presence and severity of Horner's syndrome:

1. Cocaine test - Cocaineblocks the reuptake of norepinephrineresulting in the dilationof a normal pupil. The pupil will fail to dilate in Horner's syndrome.
2. Paredrinetest
3. Dilation lag test

See also

• Anisocoria

Reference

• Horner JF. Über eine Form von Ptosis. Klin Monatsbl Augenheilk 1869;7:193-8.
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External link

• WhoNamedItentry on Horner's syndrome.
• MedlinePlus Encylopedia000708
• eMedicineoph/336de:Horner-Syndrom

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This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Horner%27s+syndrome Wikipedia article Horner's syndrome.