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Congenital Horner's syndrome is an infrequent illness caused by a lesion of the cervical sympathetic nerve fiber. It's clinical features are facial anhidrosis, ptosis, miosis, and hypochromia iridis of the affected side. The subject of this report, a full-term male newborn, had had a smooth birth process but was found on the second day of life to have narrowing of the palpebral fissure and absence of facial flushing on the right side when he cried. Ophthalmologic examination revealed a smaller right pupil. The above abnormalities proved to result from a post-ganglionic lesion, after pharmacologic test. Roentgenograms of the skull, chest and cervical spine were normal, and a computed tomography scan of the cervical spine showed no abnormalities. The diagnosis was of congenital Horner's syndrome. Since no congenital Horner's syndrome to the newborn period could be found in previous literature, this report is presented.
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PMID:Congenital Horner's syndrome: report of one case. 151 4

A Dutch family is reported with congenital Horner's syndrome in five cases spanning five generations, with symptoms of varying degree but mainly ptosis and meiosis. Heterochromia iridium, anhidrosis, and enophthalmos were not present. The site of the lesion may be in the region between Gasser's ganglion and the short vertical segment of the internal carotid artery near the siphon. There are only four previous reports showing autosomal dominant inheritance of congenital Horner's syndrome.
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PMID:Autosomal dominant congenital Horner's syndrome in a Dutch family. 154 93

The triad miosis, ptosis and hemifacial anhidrosis make up the well-known Horner's syndrome. This is caused by a lesion or a dysfunction in the "oculosympathetic pathway" running from the hypothalamus to the eye. Various disease entities may manifest themselves in this way, and it is important to be able to determine whether the dysfunction is localized to the central, preganglionic or postganglionic neurone. This review presents the various tests used for this purpose, describes our recent contributions in the field, and finally proposes a simple scheme that is suitable for topographical diagnosis.
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PMID:[Horner's syndrome. With special reference to topographical diagnosis]. 200 May 88

Horner's syndrome (cervical sympathetic paralysis) typically includes ptosis, miosis, enophthalmos and facial anhidrosis. However, the effect of sympathetic denervation upon the nasal mucosa should be included as a prominent feature, since nasal obstruction is often the most disabling sequel. The anatomical, physiological, and historical basis is discussed and surgical management suggested.
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PMID:Nasal obstruction after cervical sympathectomy: Horner's syndrome revisited. 317 78

Horner syndrome (ptosis, miosis, anhidrosis, and facial and conjunctival vasodilation) is a recognized complication of lumbar epidural analgesia for labor and delivery. Alone, it presents no significant risk to mother or fetus, as resolution is spontaneous and complete. Horner syndrome may, however, be associated with significant maternal hypotension and therefore should be an indication for close maternal and fetal monitoring to provide reassurance.
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PMID:Horner syndrome during lumbar epidural analgesia for obstetrics. 708 23

Cervical neuroblastoma is relatively rare and shows very good prognosis. We reported a case of surgically resected cervico-mediastinal neuroblastoma. A 7-month-old boy was pointed out to have Horner syndrome (right ptosis and anhidrosis) and an abnormal shadow at right cervico-mediastinum on chest X-ray film during his stay in another hospital because of acute bronchitis. On examination after admission in our hospital, 3 x 4 cm size mass was palpated at the right neck and urine VMA and HVA level were elevated. The close examination demonstrated no sign of tumor in any other organ and tissue, which suggested that the tumor was cervical origin. 9 x 5, 5 x 3 cm tumor was almost removed and patient received chemotherapy. He is now free from disease at 1 year after operation.
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PMID:[Experience with a operated cervico-mediastinal neuroblastoma in infant]. 830 10

A subcutaneous injection of 6 mg sumatriptan rapidly and effectively stopped attacks of cluster headache. After a time lag of 4-14 minutes (mean 7 minutes) pain dramatically dropped to zero within seconds to single minutes (mean 56 seconds). This rapid effect may indicate that mere vasoconstriction is the mechanism behind the beneficial effect of sumatriptan in cluster pain. The findings support a scenario in cluster headache where an inflammation in the cavernous sinus affects the sympathetic fibers traversing the cavernous region. This leads to the miosis, ptosis and forehead anhidrosis but also to a dilated internal carotid arterial tree distal to the lesion. The dilatation, in combination with an obliterated drainage of the cavernous sinus by the inflammatory process, leads to progressive stasis in the sinus, to cause the painful attack. The attack terminates when the enhanced load on the sinus is reduced by constriction of vessels supplying the sinus, as is achieved by administration of sumatriptan. The present observation that other accompanying symptoms during attacks (nasal congestion, rhinorrhea, lacrimation and swelling of eyelids) disappeared in parallel with the pain points to the possibility that these symptoms may be directly related to venous stasis or activation of pain fibers, rather than resulting from a primary parasympathetic activation.
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PMID:Subcutaneous sumatriptan in cluster headache: a time study of the effect on pain and autonomic symptoms. 838

Raeder described five patients with mixed features of trigeminal nerve pathology and oculosympathetic impairment, with or without other cranial nerve lesions. This constellation of clinical features drew the original author's attention to the paratrigeminal region as a likely site for the causative lesion in this syndrome. An analysis of the anatomy of the oculosympathetic innervation supports the view that a restricted lesion in the middle cranial fossa might cause the syndrome of trigeminal nerve involvement, neuralgic pain or sensory change, with ptosis or miosis, or both, but no anhidrosis. Such a paratrigeminal oculosympathetic syndrome (POSS) usefully reminds clinicians to pursue vigorously possible lesions of the middle cranial fossa with careful, and possibly repeated, imaging studies. Attaching the eponym Raeder's syndrome or Raeder's paratrigeminal neuralgia to this syndrome adds nothing valuable to the anatomical description (POSS), which might be preferred for clarity.
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PMID:Raeder's syndrome [corrected]: paratrigeminal paralysis of the oculopupillary sympathetic system. 1186 83

Horner's syndrome is the triad of miosis, ptosis, and anhidrosis that results from disruption of the sympathetic pathways between the brain and the eye. Although the individual signs of Horner's syndrome do not constitute an emergency, their presence makes any Horner's syndrome a potential vascular emergency due to the proximity of the internal carotid artery to the sympathetic ganglia. We present a case of Horner's syndrome in a 5-year-old child after blunt trauma to the neck, and discuss the management and implications of a potential carotid artery injury.
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PMID:A child with isolated Horner's syndrome after blunt neck trauma. 1509 49

Tube thoracostomy is a common therapeutic approach applied in medical practice. Certain complications of this procedure have been described in the literature. Oculosympathetic paresis, or Horner's syndrome, occurs from the interruption of second order preganglionic neurons and manifests as miosis, ptosis, hemifacial anhidrosis and enophthalmos. Iatrogenic Horner's syndrome, on the other hand, very rarely couples with tube thoracostomy. Only seven cases have been described in the literature, two of whom were in the pediatric age group. Herein we present a three-year-old girl operated for diaphragmatic hernia who later developed Horner's syndrome at the same side of the thorax tube. Upon the development of the pathology, the tube was repositioned and after one month only a slight ptosis persisted. Our patient seems to be the third case described in the literature. The clinical significance of this pathology is assessed in this report.
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PMID:Horner's syndrome secondary to tube thoracostomy. 1521 55


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