Horner's syndrome is a disease - described in 1869 by the Swiss ophthalmologist Friedrich Horner. Its cause is the disruption of the sympathetic innervation of the eye connecting the center in the brainstem with the eye.
Damageeyemay take place at the level of the first neuron of the hypothalamus spinal tract (e.g. in the case of a cervical injury), at the level of the secondneuronbefore the ganglion (e.g. when the sympathetic trunk is compressed bylung tumor ) or after switching fibers in the ganglia (e.g. at the level of the internal carotid artery, in cavernous sinus tumors). In children, Horner's syndrome can sometimes lead to heterochromia of the iris.
Horner's syndrome - causes
The cause ofHorner's syndromemay be the compression of the head tissues, their damage or complete breakage. It can occur as a result of trauma to the skull, the area around the eye socket and the neck. The etiology of Horner's syndrome may include: Wallenberg's syndrome, syringomyelia, spinal tumors, brainstem and sympathetic injuries, and neoplasms of the neck (lymph nodes). Sometimes Horner's syndrome is caused by the cervical rib, enlargement of the thyroid gland, enlarged lymph nodes in the neck, pathologies of the retropharyngeal space accompanied by paralysis of the bulb nerves.
Horner's syndrome - symptoms
In patients with Horner's syndrome, narrowing of the palpebral fissure on the side of the lesion (ptosis) is observed due to paralysis or weakening of the sympathetic upper and lower disc muscles. In addition, the symptom of the disease is constriction of the pupil of the eye on the affected side (miosis). This happens as a result of the action of the muscles of the pupil sphincter without the opposition of the dilator. As a result of the disorder, there is an inequality of the pupils (anisocoria). And the pupil itself stops or expands very slowly in the dark. In the case of paralysis of the sympathetically innervated orbital muscle, the eyeball collapses (enophtalmus). Often, patients with Horner's syndrome suffer from hypochromatic variegation of the irises, with the iris lighter on the affected side.
Sometimes Horner's syndrome is a symptom of another disease - a Pancoast tumor. A tumor that develops at the apex of the lung damages the sympathetic trunk by invading it. Then sympathetic activity in the area innervated by the trunk ceasessympathetic and not only the above-mentioned symptoms occur, but also the vasodilatation of the skin vessels (vasodilatio) and impaired sweat secretion in the affected part of the face (anhidrosis). Other symptoms may include changes in the composition of tears, a transient reduction in pressure in the eyeball, and apparent exophthalmia.
Horner's syndrome - treatment
Treatment of Horner's syndrome is mainly causal and is aimed at eliminating the factor causing the symptoms. Sometimes it is necessary to treat other conditions that produce different symptoms and coexist with Horner's syndrome.