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Acta Otorrinolaringologica Espanola 2012Horner's syndrome (oculosympathetic paresis) is characterised by the classic triad of ipsilateral palpebral ptosis, pupillary miosis and facial anhidrosis. The syndrome...
Horner's syndrome (oculosympathetic paresis) is characterised by the classic triad of ipsilateral palpebral ptosis, pupillary miosis and facial anhidrosis. The syndrome arises from the interruption of sympathetic innervation to the eye and adnexa at varying levels. It is a rare complication of neck surgery.We describe 6 patients who presented with Horner's syndrome after a neck procedure in our department during the last 5 years and review the different neck procedures that can cause it.
Topics: Adult; Aged; Carcinoma, Papillary; Carcinoma, Squamous Cell; Female; Ganglioneuroma; Head and Neck Neoplasms; Horner Syndrome; Humans; Hypopharyngeal Neoplasms; Male; Middle Aged; Neck; Neurilemmoma; Otorhinolaryngologic Surgical Procedures; Postoperative Complications; Retropharyngeal Abscess; Retrospective Studies; Sympathetic Fibers, Postganglionic; Thyroid Neoplasms
PubMed: 22502736
DOI: 10.1016/j.otorri.2012.01.015 -
Child's Nervous System : ChNS :... Apr 2021Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur...
PURPOSE
Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL.
METHODS
A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor.
RESULTS
Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old.
CONCLUSION
Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment.
Topics: Adolescent; Blepharoptosis; Child; Child, Preschool; Female; Horner Syndrome; Humans; Incidence; Male; Neuroblastoma; Retrospective Studies
PubMed: 33174155
DOI: 10.1007/s00381-020-04966-z -
International Ophthalmology May 2022To assess the effect of central and peripheral stimulation on the pupillary light reflex. The aim was to detect possible differences between cone- and rod-driven...
PURPOSE
To assess the effect of central and peripheral stimulation on the pupillary light reflex. The aim was to detect possible differences between cone- and rod-driven reactions.
METHODS
Relative maximal pupil constriction amplitude (relMCA) and latency to constriction onset (latency) to cone- and rod-specific stimuli of 30 healthy participants (24 ± 5 years (standard deviation)) were measured using chromatic pupil campimetry. Cone- and rod-specific stimuli had different intensities and wavelengths according to the Standards in Pupillography. Five filled circles with radii of 3°, 5°, 10°, 20° and 40° and four rings with a constant outer radius of 40° and inner radii of 3°, 5°, 10° and 20° were used as stimuli.
RESULTS
For cone-and rod-specific stimuli, relMCA increased with the stimulus area for both, circles and rings. However, increasing the area of a cone-specific ring by minimizing its inner radius with constant outer radius increased relMCA significantly stronger than the same did for a rod-specific ring. For cones and rods, a circle stimulus with a radius of 40° created a lower relMCA than the summation of the relMCAs to the corresponding ring and circle stimuli which combined create a 40° circle-stimulus. Latency was longer for rods than for cones. It decreased with increasing stimulus area for circle stimuli while it stayed nearly constant with increasing ring stimulus area for cone- and rod-specific stimuli.
CONCLUSION
The effect of central stimulation on relMCA is more dominant for cone-specific stimuli than for rod-specific stimuli while latency dynamics are similar for both conditions.
Topics: Humans; Light; Miosis; Photic Stimulation; Pupil; Reflex, Pupillary; Retinal Cone Photoreceptor Cells; Retinal Rod Photoreceptor Cells
PubMed: 34826023
DOI: 10.1007/s10792-021-02132-1 -
International Journal of Environmental... Jan 2019: In the last decade there has been a progressive increase in the use of new psychoactive substances (NPSs) that are not yet under international control. In particular,... (Review)
Review
: In the last decade there has been a progressive increase in the use of new psychoactive substances (NPSs) that are not yet under international control. In particular, novel synthetic opioids (NSOs) have reappeared on the recreational drug market in the last few years. As a result, the use of NSOs has increased rapidly. This poses an emerging and demanding challenge to public health. : To raise awareness among clinicians and other professionals about NPSs, especially NSOs, to summarize current knowledge about pharmacological properties, forms of NSO on the market, pattern of use, effects and consequences of use. : An electronic search was carried out on the Medline/PubMed and Google Scholar databases to find selected search terms. : Some NPSs are already controlled, while others can be legally sold directly on the drug market (mainly via internet, less so by drug dealers) or be used as precursors for the synthesis of other designer drugs that mimic the psychoactive effects of controlled substances. Potential side-effects of NSOs include miosis, sedation, respiratory depression, hypothermia, inhibition of gastrointestinal propulsion, death (from opioid overdose). : The severity of the opioid crisis has intensified with the introduction of highly potent NSOs on the drug market. As long as addicts are dying from overdose or similar causes, there is something more constructive to do than waiting for addicts to overdose on heroin at a place located near a remedy, as if to say, within reach of naloxone.
Topics: Analgesics, Opioid; Drug Overdose; Fentanyl; Health Knowledge, Attitudes, Practice; Humans; Illicit Drugs; Naloxone; Narcotic Antagonists; Opioid-Related Disorders; Public Health
PubMed: 30634521
DOI: 10.3390/ijerph16020177 -
Indian Journal of Ophthalmology Dec 2017The B-HEX® Pupil Expander (Med Invent Devices) is a disposable 6.5 mm flexible hexagonal device with notches at corners and flanges at sides. Alternate flanges with...
The B-HEX® Pupil Expander (Med Invent Devices) is a disposable 6.5 mm flexible hexagonal device with notches at corners and flanges at sides. Alternate flanges with positioning holes are tucked under the iris to engage the notches to the margin of the pupil to provide a 5.5 mm expanded pupil. Unlike devices with scrolls or pockets which require an injector to avoid snagging the incision, the preloaded B-HEX is inserted and removed through a 1 mm or larger incision using a manipulator or 23-gauge micro-forceps. The thin profile and uniplanar design allow unhindered instrument movement during phacoemulsification, cortical cleaning, and intraocular lens implantation. The B-HEX is safely used even after capsulorhexis since the thin uniplanar notches are directly visualized to avoid the capsule margin. It is useful in coaxial phacoemulsification, coaxial sub 2.00 mm micro incision cataract surgery (MICS), biaxial 1.5 mm MICS, femtosecond laser assisted cataract surgery (FLACS), small pupil pars plana vitrectomy, and shallow anterior chamber eyes.
Topics: Cataract; Equipment Design; Humans; Iris; Lens Implantation, Intraocular; Miosis; Phacoemulsification; Pupil; Syndrome
PubMed: 29208822
DOI: 10.4103/ijo.IJO_673_17 -
The Journal of Thoracic and... Feb 2003
Topics: Adrenergic Fibers; Anastomosis, Surgical; Angioplasty; Horner Syndrome; Humans; Infant, Newborn; Pulmonary Artery; Subclavian Artery; Surgical Flaps; Thoracotomy
PubMed: 12579132
DOI: 10.1067/mtc.2003.252 -
European Journal of Medical Research Apr 2024There have been no reports on the successful implementation of stellate ganglion block (SGB) in mice.
BACKGROUND
There have been no reports on the successful implementation of stellate ganglion block (SGB) in mice.
OBJECTIVES
This study aims to investigate a new method for implementing SGB in mice by placing them in a supine position with abducted upper limbs and touching the trachea and sternoclavicular joint with the hand.
METHODS
Fifty BABL/C mice, 8-10 weeks, were selected and randomly divided into four groups: control group (n = 5); SGB-R group (n = 15); SGB-L group (n = 15); and SGB-L + R (group n = 15). SGB was administered with 0.15% ropivacaine solution in a volume of 0.1 mL. The control group received equal volumes of saline. Horner's syndrome, heart rate, and complications such as brachial plexus block, vascular injury, pneumothorax, local anesthetic toxicity, and death were observed.
RESULTS
Horner's syndrome developed in 100% of SGB surviving mice; no difference was seen in the time to onset (100.4 ± 13.4 vs 96.7 ± 12.4, mean ± SD, seconds) and duration (264.1 ± 40.5 vs 296.3 ± 48.0, mean ± SD, min) of Horner's syndrome in the left and right SGB (P > 0.05). Compared with the control group (722 [708-726], median [IQR], bpm), the heart rate was significantly slowed down in the right SGB (475 [451.5-491], median [IQR], bpm) (P < 0.05). While the heart rate was slowed down after performing the left SGB, the difference was not statistically significant (P > 0.05). The overall complication rate was 18.4%, with a brachial plexus block rate of 12.3%, a vascular injury rate of 4.6%, and a mortality rate of 1.5%, as well as no local anesthetic toxicity (includes bilateral implementation of SGB) or pneumothorax manifestations were found.
CONCLUSIONS
This method allows for the successful implementation of SGB in a mouse model.
Topics: Animals; Mice; Anesthetics, Local; Horner Syndrome; Pneumothorax; Stellate Ganglion; Vascular System Injuries
PubMed: 38576012
DOI: 10.1186/s40001-024-01815-6 -
Journal of Vision Jan 2023It has been widely recognized that human alertness is reflected in the eyes (e.g., when drowsiness, miosis, slow saccades, divergence, less compensatory vestibulo-ocular...
It has been widely recognized that human alertness is reflected in the eyes (e.g., when drowsiness, miosis, slow saccades, divergence, less compensatory vestibulo-ocular reflex, and less-accurate optokinetic response and smooth pursuit emerge). Previous studies that discovered these pupil/oculomotor anomalous behaviors along with lowering alertness evaluated only one or a few of them simultaneously, thus their emergence order is yet unknown. Presently, we focused on the following five pupil/oculomotor behaviors that can be evaluated under a natural stationary environment without giving external sensory stimulations: saccades, slow-phase eye movements, vergence, pupil diameter, and blinks. We demonstrate that their anomalous behaviors emerge in the following order: first: frequent saccades; second: slow saccades; third: divergence & miosis, then slow eye movement, while elongated eyelid closure duration emerges randomly in this sequence. These results provide a basis for the oculo-pupillometry-enabling objective monitoring of progressive drowsiness.
Topics: Humans; Saccades; Blinking; Pursuit, Smooth; Nystagmus, Optokinetic; Miosis
PubMed: 36696121
DOI: 10.1167/jov.23.1.17 -
Journal of Veterinary Internal Medicine Mar 2023Horner syndrome often occurs with cervical myelopathies and might provide insight into the underlying disease and prognosis.
BACKGROUND
Horner syndrome often occurs with cervical myelopathies and might provide insight into the underlying disease and prognosis.
OBJECTIVES
To describe the clinical and imaging features of dogs with cervical myelopathy and concurrent Horner syndrome and to determine association of Horner syndrome with diseases or magnetic resonance images (MRI).
ANIMALS
Ninety-three client-owned dogs with cervical myelopathy and concurrent Horner syndrome and 99 randomly selected client-owned dogs with cervical myelopathy without Horner syndrome (control cases).
METHODS
Retrospective study. Medical records were reviewed to identify Horner and control cases and clinical findings recorded. MRI were reviewed, and lesions characterized and recorded. Descriptive and comparative statistics were performed.
RESULTS
Non-compressive disease occurred more frequently in the Horner group compared with controls (58%; 95% CI: 48-68 vs 9%; 95% CI: 5-16; P < .0001). The most common diseases were fibrocartilaginous embolism in the Horner group (44/93; 47%) and intervertebral disc extrusion (76/99; 77%) amongst controls. On MRI, parenchymal hyperintensity was seen more commonly in the Horner group (95%; 95% CI: 88-98) compared with controls (51%; 95% CI: 41-60; P < .0001). In the Horner group, dogs that did not survive to discharge (N = 13) had more extensive MRI lesions relative to the adjacent vertebral length (200%; IQR 110%-575%) compared with survivors (N = 80; 110%; IQR 40%-250%; P = .02). Lateralization of Horner signs and MRI changes matched in 54% of cases. The overall survival rate was high in both Horner (80/93; 86%) and control (95/99; 96%) groups.
CONCLUSIONS AND CLINICAL IMPORTANCE
Horner syndrome in cervical myelopathy is commonly associated with noncompressive intraparenchymal disease.
Topics: Dogs; Animals; Retrospective Studies; Horner Syndrome; Dog Diseases; Spinal Cord Diseases; Intervertebral Disc Displacement; Magnetic Resonance Imaging; Biomarkers
PubMed: 36704850
DOI: 10.1111/jvim.16588 -
Neuropediatrics Aug 2016Aim Horner syndrome corresponds to the clinical triad of miosis, ptosis, and facial anhidrosis. These symptoms are related to injury of the oculosympathetic chain. In... (Review)
Review
Aim Horner syndrome corresponds to the clinical triad of miosis, ptosis, and facial anhidrosis. These symptoms are related to injury of the oculosympathetic chain. In children, Horner syndrome is classified as congenital or acquired. While the diagnosis is made through clinical examination, there is some debate regarding the use of imaging modalities and the extent of anatomical coverage required. Methods Here, we describe two cases of children with acute Horner syndrome. We then review the literature about the different etiology and discuss the interest of some investigations. Results Case 1: An 8-month-old girl without personal or familial history, has presented a right acquired Horner syndrome without additional signs. Frontal chest radiography and ultrasonography of the neck and the abdomen was first achieved and returned normal. The cerebral and cervical magnetic resonance imaging (MRI) with angiographic sequences performed in a second time was also normal. Finally, an enhanced thoracic computed tomography (CT)-scan demonstrated a mass at the right pulmonary apex. Case 2: A 9-year-old boy without personal or familial history has presented an acute headache with loss of consciousness during a basketball competition. Upon waking up, the child has right hemiplegia, aphasia, and left Horner syndrome. The cerebral CT scan realized in the first line was normal. The MRI with angiographic sequences demonstrated M1 left carotid dissection with homolateral white matter infarction. Conclusion Imaging studies seem critical in delineating the nature and extent of any underlying pathology along the oculosympathetic pathway in children presenting a Horner syndrome. In these patients, a history of trauma or surgery may reduce the need for extensive systemic evaluation. Without such anamnesis, a decision to proceed with further evaluation is made with consideration of the relative incidence of tumor, especially neuroblastoma, or other treatable lesions. In this condition, MRI is the more sensitive and recommended investigation.
Topics: Basal Ganglia Cerebrovascular Disease; Brain Infarction; Carotid Artery, Internal, Dissection; Child; Female; Horner Syndrome; Humans; Infant; Lung Neoplasms; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Neuroblastoma; Tomography, X-Ray Computed
PubMed: 27148776
DOI: 10.1055/s-0036-1584085