Horner's syndrome, a rare disease caused by damage to the nerve pathways in the face

Definition

What is Horner's Syndrome?

Horner's syndrome is a group of symptoms that results from damage to the nerve pathways that extend from the brain to the face and affect one eye.

Horner's Syndrome is a fairly rare condition. Horner's syndrome is also known as Horner's-Bernard syndrome or oculosympathetic palsy.

Signs & symptoms

What are the signs and symptoms of Horner's Syndrome?

Horner's syndrome usually affects only one side of the face. The most common symptoms include:

• Shrunken pupils (miosis)
• The difference in pupil size between the two eyes is very drastic
• The pupil that shrinks late dilates in dim light or a dark room
• Drooping of the upper eyelid (ptosis)
• The lower eyelid is raised
• The affected side of the face may not sweat at all (anhidrosis), or only slightly when compared to the other side. Or, areas that do not sweat only at certain points on the face

Some of the above symptoms can be subtle, especially anhidrosis and ptosis.

Other symptoms of Horner's Syndrome that may appear in children are:

• In children under 1 year of age, the color of the iris (the middle circle of the eye) is lighter on the side of the eye that is affected
• The skin on the affected side of the face does not turn red when it is hot, sweats, or when it is angry or crying

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

You should get medical help immediately if the symptoms of Horner's Syndrome appear suddenly, after experiencing physical trauma or injury, or are accompanied by the following additional symptoms:

• Visual disturbances
• Dizzy
• Muscle weakness or difficulty controlling muscles
• Severe headache that appears suddenly; or neck pain that appears suddenly and is severe

There are a variety of risk factors for Horner's Syndrome. Some of them are more serious than others. It is important to get an accurate diagnosis immediately.

Cause

What causes Horner's Syndrome?

Horner's syndrome is caused by damage to nerve pathways in the sympathetic nervous system. The sympathetic nervous system regulates heart rate, pupil size, sweat production, blood pressure, and other bodily functions, allowing you to respond quickly to any changes in your environment.

The nerve pathways damaged by Horner's Syndrome are divided into three groups of neuron cells

First order neurons

This nerve pathway starts from the hypothalamus, which is in the lower part of the brain, extends through the brain stem and extends to the upper spine. Some of the things that can cause damage to this nerve pathway are:

• Stroke
• Tumor
• Diseases that file myelin tube membranes
• Neck trauma
• Cysts in the vertebrae (syringomyelia)

Second order neurons

This nerve pathway extends from the vertebrae to the upper chest area and side neck. Some of the things that can cause damage to this nerve pathway are:

• Lung cancer
• Tumor of the lining of the myelin tube (schwannoma)
• Damage to the blood vessels of the heart (aorta)
• Surgery in the chest area
• Traumatic injury

Third order neurons

This nerve pathway runs from the side of the neck to the facial skin and the muscles around the eyelids and the envy muscles. Some of the things that can cause damage to this nerve pathway are:

• Damage to the carotid blood vessels on the sides of the neck
• Damage to the jugular vein on the side of the neck
• Tumor or infection at the base of the skull
• Migraine
• Cluster headaches, a severe and recurring type of headache

Causes of Horner's Syndrome in children

The most common causes of Horner's Syndrome in children are:

• Injury to the neck or shoulder during childbirth
• Aortic defects at birth
• Neuroblastoma tumor

In some cases, the cause of this condition cannot be determined. This is known as Idiopathic Horner's Syndrome.

Diagnosis & Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is Horner's syndrome diagnosed?

In addition to a standard physical exam, your doctor will perform a variety of follow-up tests to determine the cause of your symptoms and an accurate diagnosis.

Tests that can be done to diagnose Horner's Syndrome

Your doctor can make a diagnosis based on your symptoms and your medical history.

The doctor, often an ophthalmologist (eye specialist), can also confirm the diagnosis by placing eye drops that can dilate / narrow the pupils on both sides of the eye. Afterwards, your doctor will compare the results of your eyes' reactions to determine if nerve damage is the cause of your condition.

Tests to identify the location of nerve damage

Doctors can tell which nerve pathways are damaged by looking at the specific symptoms that appear. The doctor may also perform additional tests or scans (scans) to detect the location of trauma or abnormalities that are interfering with the pathway of these nerves.

The doctor can confirm the diagnosis by placing eye drops, which can dilate the pupils on both sides of the eye. Afterwards, you may notice that you have Horner's Syndrome when one of the pupils of the eye is not as large as the side of the healthy eye. This is most likely the result of damage to the third nerve pathway, along the neck upwards.

In addition, doctors may perform imaging tests with MRIs, CT scans, or X-rays to determine the location of the damage that is causing Horner's Syndrome.

For children with Horner's Syndrome, the doctor may order blood and urine tests to diagnose a neuroblastoma tumor.

How is Horner's Syndrome treated?

There is no specific treatment for Horner's Syndrome. The best way to treat this condition is to treat the underlying disease or health condition.

Prevention

What are some lifestyle changes that can be made to prevent Horner's Syndrome?

Horner's syndrome is a genetic congenital disorder that can't be prevented, but its symptoms can be managed with medical therapy and drugs.

If you have any questions, consult your doctor for the best solution to your problem.

Hello Health Group does not provide medical advice, diagnosis or treatment.