How to Get Rid of Horner's syndrome
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Cause of Horner's syndrome | |
---|---|
Hemisphere and brainstem Massive cerebral infarction Pontine glioma Lateral medullary syndrome Coning of the temporal lobe |
Sympathetic chain in neck Following thryoid/laryngeal surgery Carotid artery occlusion and dissection Neoplastic infiltration Cervical sympathectomy |
Cervical cord Syringomyelia Cord tumors |
Miscellaneous Congenital Migrainous neuralgia Isolated and of unknown cause |
T1 root Bronchial neoplasm Apical tuberclosis cervical rib Brachial plexus trauma |
This collection of signs - of unilateral pupillary constriction with slight relative ptosis and enophthalmos - indicates a lesion of the sympathetic pathway on the same side. The conjunctival vessels are slightly injected. There is loss of sweating of the same side of the face or body; the extent depending upon the level of the lesion:
- Central lesions affect sweating over the entire half of the head, arm and upper trunk.
- Neck lesions proximal to the superior cervical ganglion cause diminished facial sweating.
- Lesions distal to the superior cervical ganglion do not affect sweating at all.
Pharmacological tests help to indicate the level of the lesion. For example, a lesion distal to the superior cervical ganglion causes denervation hypersensitivity of the pupil, which dilates when 1:1000 adrenaline (epinephrine) is instilled. This dose has little effect on the normal pupil or a Horner's pupil from a proximal lesion. In clinical practice the test is of limited value.

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