Horner's syndrome

Question 1

Define:

Answer 1

A condition that results from the disruption of the symp nerves that supply the face

Question 2

Aetiology/risk factors:

Answer 2

Symptoms arise on the ipsilateral side of the face

o Brainstem: demyelination, vascular disease, stroke
o Cord: syringomyelia (a cyst or cavity in the spinal cord)
o Thoracic outlet: Pancoast’s tumour (apical lung tumour)
o On the sympathetic’s trip on the internal carotid artery into the skull (carotid artery dissection)
o At the orbit

Question 3

Epidemiology:

Answer 3

Rare

Important to pick up for other disease such as pancost tumours

Question 4

Symptoms:

Answer 4

Inability to open eye fully on the affected side

Lack of sweating on the affected side

Facial flushing

Orbital pain/headache

Other symptoms are based on the cause

Question 5

Investigations:

Answer 5

Aimed at finding the cause of horner’s syndrome

CXR - apical lung tumours

CT angiography - carotid dissection

CT/MRI - cerebrovascular accidents

Question 6

Signs:

Answer 6

Ptosis
Miosis (pupil constriction)
Anhydrosis
Enophthalmos

Question 7

Management/complications/prognosis:

Answer 7

Depends on the cause as horner’s is not a disease but rather a sign