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Horner's Syndrome, Emergency Medicine

Richard S. Krause Reviewed 06/2017
 


Basics

Description

Unilateral sympathetic denervation of the eye produces signs of Horner's syndrome: 
  • Relaxation of retracting muscles in upper and lower lids:

    • Ptosis (drooping of the lids)

  • Loss of pupil...

Diagnosis

Signs and Symptoms

  • Horner's syndrome is characterized by:

    • Ptosis: Drooping of eyelid on affected side, usually slight

    • Miosis: Decrease in pupillary size on involved side (pupillary asymmetry ≥1...

Treatment

Pre-Hospital

Cautions: 
  • The importance of Horner's syndrome is its association with more serious underlying conditions.

  • Patients with increased ICP or tension pneumothorax must be recognized an...

Follow-Up

Disposition

Admission Criteria

Admission for isolated Horner's syndrome is not needed: 
  • Admission may be needed for underlying condition.

Discharge Criteria

  • Stable patients with isolated Horner's...

Pearls and Pitfalls

Must consider underlying etiology 

Additional Reading

  • Debette  S, Leys  D. Cervical-artery dissections: Predisposing factors, diagnosis, and outcome. Lancet Neurol.  2009;8(7):668–678.

  • Maloney  WF, Younge  BR, Moyer  NJ. Evaluation...

Codes

ICD9

  • 337.9 Unspecified disorder of autonomic nervous system

  • 374.30 Ptosis of eyelid, unspecified

  • 379.42 Miosis (persistent), not due to miotics

  • 705.0 Anhidrosis

ICD10

  • G90.2 Horner's syndrome

  • H02.409 Un...

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