Horners Syndrome

Clinical:

• Ptosis
• Meiosis (usu mild)
• Anhidrosis
• Of whole body and face – brainstem lesion
• Of face neck and arm – cervical lesion
• No impairment – lesion above bifurcation of carotid

Anatomy

• 3 neurons:

1. Thalamus – brainstem – T1 cord
2. Cord to superior cervical ganglion
3. Superior cervical ganglion through neck near carotid to orbit

Causes

• First (Central) Neuron 63%
• Brainstem infarction
• Cerebral infarction/haemorrhage
• MS
• Tumour
• Trauma
• Syrinx
• Transverse myelopathy
• Second (Preganglionic) Neuron 21%
• Thoracic/neck tumour
• Trauma
• Third (Postganglionic) Neuron 13%
• Intracranial tumour (Cavernous sinus)
• Trauma
• Vascular headache
• Unknown 3%