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Pathology
Miosis, ptosis and anhydrosis caused by lesions in the oculosympathetic pathway
Aetiology
Central: Lesions involving hypothalamus, brain stem and cervical cord such as
infarct, bleed and demyelination
Preganglionic: Cervicothoracic cord trauma, tumors or syrinx, lower brachial
plexus injuries, apical lung tumors, cervical rib
Postganglionic: Migraine, cluster headache, internal carotid artery dissection,
cavernous sinus pathologies
Signs
Miosis, ptosis and anhydrosis on one side of the face
Symptoms
Usually mild and can go unnoticed by patient is.
Investigations
Special tests: Apraclonidine test (topical alpha agonist which constricts normal eye
and reverses Horner’s eye) help confirm the diagnosis
Imaging: Chest X-ray: to identify apical tumour
MRI/CT: to assess to underlying pathologyis.Treatment
Conservative: Symptoms of Horner’s syndrome are usually mild and do not require
any intervention.
Surgical: Correction of ptosis could be considered in some cases.
Prognosis
Dependent on underlying cause.
Key Facts
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Key Images
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Key References
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