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Horner Syndrome

Iain W. Decker, DO and Zaiba Malik, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Horner syndrome is a constellation of neurological signs and symptoms manifested as a classic triad of ipsilateral miosis, eyelid ptosis, and anhidrosis of the ipsilateral face and/o...

DIAGNOSIS

HISTORY

  • When did symptoms begin? (acute vs. chronic)

  • Any visual symptoms? (blurred vision, field loss, transient visual loss, diplopia)

  • Previous ophthalmic history? (eye trauma, surgery)

  • Are sym...

TREATMENT

GENERAL MEASURES

  • Treatment generally revolves around addressing any underlying etiologies.

  • Once life-threatening etiologies have been excluded, cosmesis or functional vision impairment due to ...

ONGOING CARE

PROGNOSIS

  • Postganglionic: usually benign

  • Central and preganglionic: poorer prognosis

COMPLICATIONS

  • Chronic pupillary constriction

  • Cosmesis

REFERENCES

1
Chen Y, Morgan ML, Barros Palau AE, et al. Evaluation and neuroimaging of the Horner syndrome. Can J Ophthalmol.  2015;50(2):107–111.
2
Antonio-Santos AA, Santo RN, Eggenberger ER. Phar...

ADDITIONAL READING

  • Lyrer PA, Brandt T, Metso TM, et al. Clinical import of Horner syndrome in internal carotid and vertebral artery dissection. Neurology.  2014;82(18):1653–1659.

  • Mahoney NR, Liu G...

CODES

ICD10

  • G90.2 Horner’s syndrome

  • S14.5XXA Injury of cervical sympathetic nerves, initial encounter

ICD9

  • 337.9 Unspecified disorder of autonomic nervous system

  • 954.0 Injury to cervical sympathetic nerve,...

CLINICAL PEARLS

  • Horner syndrome triad: ipsilateral miosis, eyelid ptosis, and anhidrosis caused by a lesion of the oculosympathetic pathway

  • Red flag: Horner syndrome in the presence of acute-onset, ips...

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