Horner's syndrome

  • Horner’s syndrome is a condition caused by damage to the sympathetic nervous system (cervical sympathetic chain or central pathways)
  • Clinical features:
    • Ptosis (paralysis of muller’s muscle – part of levator palpebrae superioris)
    • Miosis (constricted pupil – sympathetic supply is responsible for dilation of pupil)
    • Anhidrosis (decreased sweating on affected side of face)
    • Enophthalmos (appearance of a sunken eyeball – apparent rather than real) – Read Mechanism of enophthalmos in Horner’s syndrome
    • Loss of ciliospinal reflex
  • Diagnosis
    • Can be easily diagnosed by clinical signs
    • In case of doubtful cases, it can be confirmed by instilling 4% cocaine eyedrops
      • Cocaine acts by blocking uptake of adrenaline
      • In normal eye, it causes mydriasis (dilatation of pupil)
      • In Horner’s syndrome, there is no mydriasis as adrenaline is not released
  • Also known as (synonyms)
    • Bernard-Horner syndrome
    • Oculosympathetic palsy

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