Condition- Horner's Syndrome

Question 1

What is horner’s syndrome?

Answer 1

A condition caused by disruption of the sympathetic nerves supplying the face –> triad:

• Partial ptosis
• Miosis
• Anhydrosis

(and enopthalmos- sunken eye)

Question 2

List some conditions that could cause Horners… (go through the different locations where the sympathetic nerves could be affected)

Answer 2

Caused by disruption to sympathetic nerves- disruption can be at different locations:

• Brainstem: demyelination, vascular disease, stroke
• Cord: syringomyelia
• Thoracic outlet: pancoast’s tumour (apical lung tumour)
• On the sympathetic’s trip on the internal carotid aretry into the skull (carotid artery dissection)
• At the orbit

Question 3

What are some of the presenting symptoms of horners?

Answer 3

• 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 4

If you noticed that your patient had Horner’s which investigations would you conduct?

Answer 4

Need to find cause:

• CXR- apical lung tumour
• CT/MRI- cerebrovascular accident
• CT angiography-dissection