Evaluation of the Causes and Accuracy of Pharmacologic Localization in Horner's Syndrome

Maloney, William F.; Younge, Brian R.; Moyer, Norma J.

doi:10.1016/s0002-9394(14)74924-4

Cited by 193 publications

(101 citation statements)

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“…8 Similarly, sympathetically innervated muscle is found in the lower lid, and therefore the lower lid may be elevated, producing an 'upside-down ptosis'. With overall palpebral aperture reduction, the globe can appear enophthalmic.…”

Section: Anatomical Localisation In Relation To Clinical Signsmentioning

confidence: 99%

Adult Horner’s syndrome: a combined clinical, pharmacological, and imaging algorithm

Davagnanam

Fraser

Miszkiel

et al. 2013

Eye

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The diagnosis of Horner's syndrome (HS) can be difficult, as patients rarely present with the classic triad of ptosis, miosis, and anhydrosis. Frequently, there are no associated symptoms to help determine or localise the underlying pathology. The onset of anisocoria may also be uncertain, with many cases referred after incidental discovery on routine optometric assessment. Although the textbooks discuss the use of cocaine, apraclonidine, and hydroxyamphetamine to diagnose and localise HS, in addition to reported false positive and negative results, these pharmacological agents are rarely available during acute assessment or in general ophthalmic departments. Typically, a week is required between using cocaine or apraclonidine for diagnosis and localisation of HS with hydroxyamphetamine, leaving the clinician with the decision of which investigations to request and with what urgency. Modern imaging modalities have advanced significantly and become more readily available since many of the established management algorithms were written. We thus propose a practical and safe combined clinical and radiological diagnostic protocol for HS that can be applied in most clinical settings.

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Section: Anatomical Localisation In Relation To Clinical Signsmentioning

confidence: 99%

Adult Horner’s syndrome: a combined clinical, pharmacological, and imaging algorithm

Davagnanam

Fraser

Miszkiel

et al. 2013

Eye

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“…3 The preganglionic (second-order) neuron for sympathetic supply to the eye begins in the ciliospinal centre of Budge between the eighth cervical vertebra and the fourth thoracic vertebra (C8-T4) of the spinal cord. The axons exit the spinal cord via the anterior horn, pass through the pulmonary apex and enter the sympathetic chain in the neck, synapsing in the superior cervical ganglion.…”

Section: Commentmentioning

confidence: 99%

Neurofibromatosis type 1 presenting with Horner's syndrome

Cackett

Vallance

Bennett

2004

Eye

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“…La interrupción de la vía oculosimpáti-ca en cualquier punto de su recorrido puede provocar miosis en el 98% de los casos, ptosis palpebral incompleta hasta en un 88% de los casos y anhidrosis en un 4% si la lesión de la vía simpática se encuentra por debajo del ganglio cervical superior 3 . Otros signos y síntomas más infrecuentes son anisocoria e hiperemia conjuntival 4 .…”

Section: Introductionunclassified

“…Los tumores son una de las causas conocidas más frecuentes, representando aproximadamente el 13% de todos los casos. Sin embargo, hay muchas causas no malignas del SH en adultos y niños 3 . La patología subyacente del SH es aparente en más del 80% de los pacientes en el momento de la primera consulta neuroftalmológica, basada en la historia clínica o localización de la lesión 7 .…”

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Horner's Syndrome: an unusual ophthalmological presentation of Hodgkin lymphoma

Azanza

Cortaire

Ramos

2017

An Sist Sanit Navar

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c. abascal azanza, R. abárzuza cortaire, P. Plaza Ramos REsUMEn El Síndrome de Horner (SH) es un síndrome neuroló-gico que se caracteriza por la triada miosis pupilar incompleta, ptosis palpebral y anhidrosis facial debido a la lesión de la vía oculosimpática, compuesta por tres neuronas, desde el hipotálamo hasta el ojo. Identificar su causa representa un reto diagnóstico ya que, a pesar de su aparente levedad clínica, el SH puede ser la primera o única manifestación de un trastorno grave o incluso potencialmente mortal. Presentamos el caso de un paciente varón de 19 años con una historia de molestias oculares inespecíficas de dos meses de evolución. Acudió a la consulta de urgencias de Oftalmología en la que fue diagnosticado de un SH como primera manifestación clínica de linfoma de Hodgkin. aBstRactHorner's Syndrome (HS) is a neurological syndrome characterised by the triad incomplete pupillary miosis, palpebral ptosis and facial anhidrosis, due to a lesion of the oculosympathetic pathway, formed of three neurons from the hipothalamus to the eye. Identifying its cause is a diagnostic challenge since in spite of its apparent lack of clinical importance, HS can be the first or only manifestation of a serious, or even potentially mortal disorder. We present the case of a 19-year-old male patient with a history of nonspecific ocular pains of two months evolution. He attended the emergency ophthalmological clinic where he was diagnosed with an HS as the first clinical manifestation of Hodgkin lymphoma.

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Evaluation of the Causes and Accuracy of Pharmacologic Localization in Horner's Syndrome

Cited by 193 publications

References 10 publications

Adult Horner’s syndrome: a combined clinical, pharmacological, and imaging algorithm

Adult Horner’s syndrome: a combined clinical, pharmacological, and imaging algorithm

Neurofibromatosis type 1 presenting with Horner's syndrome

Horner's Syndrome: an unusual ophthalmological presentation of Hodgkin lymphoma

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