Horner Syndrome

Description

Horner syndrome is associated with an interruption to the sympathetic nerve supply of the eye. It is characterized by the classic triad of miosis, partial ptosis, and anhidrosis +/- enophthalmos

Horner Syndrome may occur secondary to:

• Local compression of brachial plexus and sympathetic chain by superior (pulmonary) sulcus tumors.(e.g. Pancoast tumor)
• Brainstem stroke
• Carotid artery aneurysm (dissection) or critical ischaemia
• Trauma involving the brachial plexus
• Neoplasm of the middle cranial fossa

History

1869 –  Johann Friedrich Horner reported the findings of ptosis, miosis, and enophthalmos in a 40-year-old peasant woman. He also observed increased skin temperature and dryness of the ipsilateral face.

He pharmacologically confirmed the impairment of sympathetic innervation to the eye after noting poor dilation of the affected pupil following instillation of atropine and preserved pupillary constriction to the parasympathomimetic agent calabar. [1869;7:193-198]

Associated Persons

• Johann Friedrich Horner (1831 – 1886)

Alternative names

• Horner’s syndrome
• Bernard-Horner syndrome (France)
• Claude Bernard syndrome
• Von Passow syndrome

References

• Horner JF. Über eine Form von Ptosis. Klinische Monatsblätter für Augenheilkunde 1869;7:193-198
• LITFL Clinical Case – Ophthalmology Befuddler 025
• CCC – Horner syndrome