Horner syndrome

2021-08-04 04:53 PM

Horner syndrome is not a disease. Rather, it's a sign of a medical problem - like a tumor, stroke, or spinal cord injury, damage to the nerves to the face.

Define

Horner syndrome is a rare syndrome that occurs when the nerves going from the brain to the eyes and face are damaged.

Horner syndrome usually affects only one side of the face. Confirming findings of Horner syndrome include a drooping eyelid, reduced pupil size, and decreased sweating on the affected side of the face.

Horner syndrome is not a disease. Rather, it's a sign of a medical problem - like a tumor, stroke, or spinal cord injury, damage to the nerves to the face. However, in some cases, no underlying cause is found.

There is no specific treatment for Horner syndrome. Instead, treatment is directed at the underlying cause, when possible.

Symptoms

Signs and symptoms of Horner syndrome usually occur on one side of the face and often include:

Lower eyelid droop (ptosis) and low upper eyelid elevation.

Reduce the size of the affected eye.

Reduced or absent sweating on the affected side of the face (anhidrosis).

Rarely a baby can be born with Horner syndrome. In these cases, the pupil in the affected eye is lighter in color than in the other eye.

If you notice any of the signs or symptoms associated with Horner syndrome, see your doctor.

Causes

Horner syndrome is caused by damage to the sympathetic nerves of the face and eyes. Sympathetic nerves control the body's circulation and perspiration.

The facial sympathetic nerve does not travel directly from the brain to the face. Instead, it starts in the area of ​​the brain called the hypothalamus, travels through the brain, and then down the spine to enter the chest. From the chest, it goes back up the neck, next to the carotid arteries into the skull, and then to the eyes. If the nerve is injured at any point along this route, Horner syndrome can result. Signs and symptoms of Horner syndrome usually occur on one side of the face because the sympathetic nerves control each side separately.

Problems that can damage sympathetic nerve fibers and cause Horner syndrome include:

Stroke.

Tumor.

Spinal cord injury.

Syringomyelia - a condition in which fluid-filled cysts develop in the spinal cord.

The inner lining of the carotid artery is torn.

Recurrent migraine or migraine.

Injury during childbirth.

Although Horner syndrome can be a sign of one of these problems, in some situations a specific cause cannot be found. This is called idiopathic Horner syndrome.

Testing and diagnosis

To diagnose Horner syndrome, your doctor will begin by taking your medical history and doing a thorough physical exam.

Pupil dilation test. If you have Horner's syndrome, your pupils will dilate more slowly than usual. Your doctor can evaluate by putting drops in the eye to dilate. The eye's reaction to the eye drops will help confirm or deny the diagnosis of Horner's syndrome.

Follow-up test. Clinical examination and dilated pupils can confirm the diagnosis of Horner syndrome. However, finding the underlying cause of Horner syndrome will most likely require other tests. Depending on the situation may include:

Magnetic resonance imaging (MRI) of the head, neck, and chest to identify tumors, signs of stroke, damage to the carotid arteries, and other problems that can affect the sympathetic nerves in the face.

Blood tests or urine tests to detect substances produced by cancer.

Treatments and drugs

There is no specific treatment for Horner syndrome. Treatment depends on the cause. Usually, Horner's syndrome goes away when the underlying medical problem is effectively treated.

If you have trouble seeing the affected eye, your doctor may recommend follow-up by an eye doctor (ophthalmologist).