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Central nervous system
Central nervous system


Horner syndrome

Definition:

Horner syndrome is a rare condition that affects the nerves to the eye and face.



Causes, incidence, and risk factors:

Horner syndrome can be caused by any interruption in a set of nerve fibers that start in the part of the brain called the hypothalamus and run to the face.

Sympathetic nerve fiber injuries can result from:

  • Injury to one of the main arteries to the brain (carotid artery)
  • Injury to nerves in the neck called the brachial plexus
  • Migraine or cluster headaches
  • Stroke , tumor, or other damage to a part of the brain called the brainstem
  • Tumor in the top of the lung

Rarely, Horner syndrome may be present at birth (congenital). The condition may occur with a lack of color (pigmentation) of the iris (colored part of the eye).



Symptoms:
  • Decreased sweating on the affected side of the face
  • Drooping eyelid (ptosis )
  • Sinking of the eyeball into the face
  • Small (constricted) pupil (the black part in the center of the eye)

There may also be symptoms of the disorder that is causing the problem.



Signs and tests:

An eye examination may show:

  • Changes in how the pupil opens or closes
  • Eyelid drooping

A complete medical and nervous system (neurological) examination can show whether any other parts of the body are affected.

Other tests may include:

You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).



Treatment:

Treatment depends on the cause of the problem. There is no treatment for Horner syndrome itself.



Support Groups:



Expectations (prognosis):

The outcome depends on whether treatment of the cause is successful.



Complications:

There are no direct complications of Horner syndrome itself. However, there may be complications from the disease that caused Horner syndrome or from its treatment.



Calling your health care provider:

Call your health care provider if you have symptoms of Horner syndrome.



Prevention:



References:

Baloh RW. Neuro-ophthalmology. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 450.

Saper CB. Autonomic disorders and their management. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 445.




Review Date: 6/15/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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