Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
DescriptionUnilateral 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 pupillary dilator innervation:
- Miosis (unopposed pupillary constriction)
- Loss of sympathetic stimulation of sweat glands:
- 40% unknown (in 1 large series)
- Tumors of lung or metastases to cervical nodes:
- May interrupt preganglionic sympathetic fibers (between thoracic sympathetic trunk and superior cervical ganglion)
- Trauma: Penetrating neck wounds directly injure sympathetic fibers
- Tension pneumothorax may cause traction on sympathetic fibers owing to shift of mediastinal structures.
- Infiltration or infection of cervical nodes:
- Sarcoidosis, tuberculosis
- Vascular disorders:
- Migraine or cluster headaches
- Carotid artery dissection
- Lateral medullary infarction produces Horner's syndrome as part of the Wallenberg syndrome:
- Presents with vertigo and ataxia, which may overshadow the Horner's syndrome.
- Cavernous sinus thrombosis may present with some of the features of Horner's syndrome:
- The condition typically causes headache and/or eye pain.
- Ocular signs include ocular palsies, pain, chemosis, and proptosis.
- Hereditary Horner's syndrome:
- Blue iris (or irregular coloration) on affected side
- Brown on unaffected side (heterochromia iridis)
- Birth trauma:
- May cause damage to sympathetic chain
- New Horner's syndrome in a child should prompt workup for tumor (neuroblastoma).