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Horner Syndrome

Reviewed 06/2018
 


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 midface an...

DIAGNOSIS

HISTORY

  • Symptoms presented from birth? Presentation is acute or progressive?

  • Is there any associated headaches or double vision?

  • Does the degree of ptosis vary over the course of the day or wit...

TREATMENT

GENERAL MEASURES

  • Horner syndrome itself does not produce any disability or necessarily require treatment.

  • Treat the underlying etiology.

  • Search for a tumor or other compressive lesion.

MEDICATION

ONGOING CARE

PROGNOSIS

  • Postganglionic: usually benign

  • Central and preganglionic: poorer prognosis

COMPLICATIONS

  • Chronic pupillary constriction

  • Cosmesis

REFERENCES

1
Gross J, McClelland C, Lee M. An approach to anisocoria. Curr Opin Ophthalmol.  2016;27(6):486–492. [View Abstract on OvidMedline]
2
Knyazer B, Smolar J, Lazar I, et al. Iatrogenic Hor...

ADDITIONAL READING

  • Ahmadi O, Saxena P, Wilson BK, et al. First rib fracture and Horner’s syndrome: a rare clinical entity. Ann Thorac Surg.  2013;95(1):355. [View Abstract on OvidMedline]

  • Almog Y...

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

  • Horner syndrome in the presence of acute-onset, ipsilateral f...

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