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The Canadian Veterinary Journal = La... Jan 2019Horner's syndrome arises from dysfunction of the oculosympathetic pathway and is characterized by miosis, enophthalmos, protrusion of the third eyelid, and ptosis. It... (Review)
Review
Horner's syndrome arises from dysfunction of the oculosympathetic pathway and is characterized by miosis, enophthalmos, protrusion of the third eyelid, and ptosis. It has been recognized in a wide variety of breeds and ages in small animal patients. The oculosympathetic pathway is a 3-neuron pathway. The central/first order neuron arises from the hypothalamus and extends down the spinal cord. The preganglionic/second order neuron arises from the first 3 thoracic spinal cord segments and travels through the thorax and cervical region until it synapses at the cranial cervical ganglion. The postganglionic/third order neuron travels from this ganglion to the orbit. Topical application of cocaine is the gold standard for differentiating Horner's syndrome from other causes of miosis. Topical 1% phenylephrine allows for identification of a post-ganglion Horner's syndrome. Numerous etiologies have been reported for Horner's syndrome, but idiopathic disease is most common. Ancillary diagnostics include otoscopic examination, thoracic radiographs, or advanced imaging. Treatment and prognosis are determined by the etiology.
Topics: Animals; Cat Diseases; Cats; Cocaine; Dog Diseases; Dogs; Horner Syndrome; Ophthalmic Solutions
PubMed: 30651655
DOI: No ID Found -
Ugeskrift For Laeger Apr 2022
Topics: Carotid Artery, Internal; Carotid Artery, Internal, Dissection; Horner Syndrome; Humans
PubMed: 35410649
DOI: No ID Found -
Clinical & Experimental Optometry Sep 2007Horner syndrome is an uncommon but important clinical entity, representing interruption of the sympathetic pathway to the eye and face. Horner syndrome is almost always...
Horner syndrome is an uncommon but important clinical entity, representing interruption of the sympathetic pathway to the eye and face. Horner syndrome is almost always diagnosed clinically, though pharmacological testing can be used to confirm the diagnosis. Imaging modalities such as PET, CT and MRI are important components of work-up for patients presenting with acquired Horner syndrome. Our patient's presentation with Horner syndrome unmasked the causative superior sulcus squamous cell carcinoma and a coincidental lower lobe adenocarcinoma. Successful radical treatment of these cancers resulted in complete resolution of the syndrome and disease-free survival at 18 months. We review the anatomy and pathophysiology underlying this and other causes of Horner syndrome.
Topics: Biopsy, Fine-Needle; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Horner Syndrome; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Middle Aged; Positron-Emission Tomography; Tomography, X-Ray Computed
PubMed: 17697179
DOI: 10.1111/j.1444-0938.2007.00177.x -
CMAJ : Canadian Medical Association... Aug 2008A patient was noted to have 2 different eye colours and miosis in her left eye. She ultimately received a diagnosis of congenital Horner syndrome. Determinants of eye...
A patient was noted to have 2 different eye colours and miosis in her left eye. She ultimately received a diagnosis of congenital Horner syndrome. Determinants of eye colour and possible clinical significance are discussed.
Topics: Adult; Diagnosis, Differential; Eye Color; Female; Follow-Up Studies; Horner Syndrome; Humans; Iris Diseases
PubMed: 18725617
DOI: 10.1503/cmaj.070497 -
Neurologia 2021
Topics: Horner Syndrome; Humans; Syndrome
PubMed: 34266796
DOI: 10.1016/j.nrleng.2021.02.002 -
Journal of Cardiothoracic and Vascular... Jun 2020THE RISK FACTORS, clinical manifestation, and preventive measures of Horner syndrome (HS) caused by internal jugular vein (IJV) catheterization were explored. Electronic... (Review)
Review
THE RISK FACTORS, clinical manifestation, and preventive measures of Horner syndrome (HS) caused by internal jugular vein (IJV) catheterization were explored. Electronic databases were searched to identify all case reports of HS caused by IJV catheterization. Two authors independently extracted literature characteristics, IJV catheterization method, clinical manifestations, and prognosis data. Twenty case reports (22 patients in total) were included, 18 of which were written in English and the other 2 in Chinese. Patients were between 19 months to 65 years old, and clinical manifestations included ptosis (n = 22), miosis (n = 21), anhidrosis (n = 8), enophthalmos (n = 3), and hoarseness (n = 1). Onset of HS manifestation ranged from a few hours to 19 days after the procedure. Eight patients with ptosis, 6 patients with miosis, and 1 patient with hoarseness recovered during follow-up. Of the 22 patients, 8 underwent more than 1 attempt of IJV catheterization. Six patients experienced accidental carotid artery puncture or hematoma formation during or after IJV catheterization. Ultrasound guidance was applied in 4 patients and anatomic landmark technique was used in the other 18 patients. The left IJV was catheterized in 3 patients, and the right IJV was catheterized in 19 patients. Repeated attempts of puncture, anatomic landmark technique, accidental carotid artery puncture, or hematoma formation may increase the possibility of HS. Ptosis and miosis are the most common manifestations of HS caused by IJV catheterization.
Topics: Carotid Arteries; Catheterization, Central Venous; Horner Syndrome; Humans; Jugular Veins; Ultrasonography
PubMed: 31350153
DOI: 10.1053/j.jvca.2019.06.031 -
The Canadian Veterinary Journal = La... Sep 2017
Topics: Animals; Dog Diseases; Dogs; Horner Syndrome; Male
PubMed: 28878425
DOI: No ID Found -
The British Journal of Ophthalmology Aug 1977Altogether 85 eyes from patients at risk to the development of closed-angle glaucoma were dilated with either parasympatholytic or sympathomimetic drugs. Of 21 eyes...
Altogether 85 eyes from patients at risk to the development of closed-angle glaucoma were dilated with either parasympatholytic or sympathomimetic drugs. Of 21 eyes dilated with cyclopentolate 1/2%, 9 developed angle closure and a significantly raised pressure at some stage during dilatation and subsequent miosis. Of 58 eyes dilated with tropicamide 1/2%, 19 developed angle closure and a significantly raised pressure during dilatation. Treatment with intravenous acetazolamide and pilocarpine rapidly returned pressure to normal levels. Six eyes that had previously had a positive provocative test with simultaneous pilocarpine and phenylephrine were safely dilated with phenylephrine alone. Subsequent miosis with pilocarpine produced closed-angle glaucoma in all eyes. The significance of these observations is explained and discussed, and it is suggested that high-risk eyes should never be dilated with cyclopentolate. Tropicamide is safe if elementary precautions are observed. Safest of all, however, is phenylephrine-induced mydriasis and subsequent miosis with thymoxamine drops 1/2%.
Topics: Acetazolamide; Cyclopentolate; Glaucoma; Humans; Miotics; Moxisylyte; Mydriatics; Phenylephrine; Pilocarpine
PubMed: 143952
DOI: 10.1136/bjo.61.8.517 -
BMJ Case Reports Aug 2017Horner's syndrome (HS) is caused by a disruption in the oculosympathetic pathway. Both congenital and acquired HS are unusual in children. Acquired HS can be caused by...
Horner's syndrome (HS) is caused by a disruption in the oculosympathetic pathway. Both congenital and acquired HS are unusual in children. Acquired HS can be caused by trauma, surgical intervention, tumours, vascular malformations or infection.We describe the case of a 6-year-old boy who was brought to our emergency department with ptosis, miosis, painful cervical lymphadenopathy and a cat scratch on a hand. The diagnosis of a cat scratch disease was confirmed by serology. A full recovery was observed on antibiotic treatment and cervical lymphadenomegaly reduction 3 weeks later.
Topics: Animals; Anti-Bacterial Agents; Bartonella Infections; Bartonella henselae; Blepharoptosis; Cat-Scratch Disease; Cats; Child; Emergency Service, Hospital; Horner Syndrome; Humans; Lymphadenopathy; Male; Miosis; Neck; Treatment Outcome
PubMed: 28839109
DOI: 10.1136/bcr-2017-219673 -
Tidsskrift For Den Norske Laegeforening... May 2011Horner's syndrome is characterized by the classic triad of eyelid ptosis, miosis and facial anhidrosis and is caused by an interruption of the oculosympathetic nerve... (Review)
Review
BACKGROUND
Horner's syndrome is characterized by the classic triad of eyelid ptosis, miosis and facial anhidrosis and is caused by an interruption of the oculosympathetic nerve pathway somewhere between its origin in the hypothalamus and the eye.
MATERIAL AND METHODS
This review is based on own experiences and a discretionary selection of articles found through non-systematic searches in PubMed. Cases from own practice serve as examples.
RESULTS
Based on localization of the nerve pathway interruption, a Horner's syndrome is often classified as central, pre- or postganglionic. For the central type the syndrome is associated with other symptoms and signs from the central nervous system. The preganglionic type is most often caused by a tumor or trauma. The postganglionic type is often associated with pain/headache; most frequently it is seen as a consequence of carotid artery dissection or during cluster headache. Anhidrosis is rarely prominent, and in the postganglionic subtype it is virtually absent. Pharmacological tests can be used in diagnostics. Apraclonidine seems to be a good alternative to cocaine to confirm Horner's syndrome. MRI is generally recommended in the evaluation, if necessary with special sequences.
INTERPRETATION
The path of the long oculosympathetic fibers is complex and not fully understood. Topographic diagnostics may be challenging, but in most cases a specific cause is identified.
Topics: Adrenergic alpha-2 Receptor Agonists; Adult; Aged; Clonidine; Cocaine; Diagnosis, Differential; Female; Headache; Horner Syndrome; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Ophthalmic Solutions; Reflex, Pupillary; Sympathomimetics
PubMed: 21606992
DOI: 10.4045/tidsskr.10.0935