Materiały źródłowe

• #1 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  Horner syndrome is a rare condition classically presenting with partial ptosis (drooping or falling of the upper eyelid), miosis (constricted pupil), and facial anhidrosis (absence of sweating) due to a disruption in the sympathetic nerve supply. […] Treatment options are based on the diagnosis and management of the underlying cause. Timely diagnosis is of critical importance, followed by referral to an appropriate specialist. Healthcare professionals are advised to incorporate the importance of eye examinations into their acumen. […] There are many causes of Horner syndrome and thus the condition is best managed by an interprofessional team that includes nurse practitioners. The key is to determine the location of the eye defect. Thus, it is important to perform a detailed systemic examination, paying specific attention to neurological, pulmonary, and cardiovascular systems and considering various differentials discussed later.

• #2 CE Activity | Horner Syndrome | Nurses

  https://www.statpearls.com/nurse/ce/activity/102111

  Horner syndrome is a rare condition classically presenting with partial ptosis (drooping or falling of the upper eyelid), miosis (constricted pupil), and facial anhidrosis (absence of sweating) due to a disruption in the sympathetic nerve supply. […] Treatment is centered around the identification and appropriate management of the underlying cause. This activity reviews the evaluation and management of Horner syndrome and highlights the role of the interprofessional team in the management of affected patients. […] Outline the management options available for patients with Horner syndrome. […] Summarize interprofessional team strategies for improving care coordination and communication to advance the diagnosis and treatment of Horner syndrome and improve patient outcomes. […] Nurses should only claim credit commensurate with the extent of their participation in the activity.

• #3 Horner’s Syndrome in Cats | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/horners-syndrome-in-cats

  Horner’s syndrome is a common neurological disorder of the eye and facial muscles, caused by dysfunction of the sympathetic nervous system. […] The most common clinical signs of Horner’s syndrome are: the upper eyelids droop on the affected side (ptosis), the pupil of the eye on the affected side is constricted, or smaller than usual (miosis), the eye of the affected side often appears sunken (enophthalmos), the third eyelid of the affected side may appear red and raised or protruded (conjunctival hyperemia). […] Depending on your cat’s recent history and other physical findings on examination, your veterinarian may recommend a series of diagnostic tests to determine if there is an underlying cause. […] Most cases of Horner’s syndrome resolve spontaneously. Since your cat may have an inability to blink normally, your veterinarian may recommend symptomatic treatment in the form of eye lubricants to minimize the development of corneal ulcers from what is called exposure keratitis. […] The prognosis depends on the underlying cause. Patients with chest trauma tend to have a quicker recovery rate (days to weeks) than patients with other lesions. If the underlying problem is feline dysautonomia, the prognosis is poor.

• #4 Horner’s Syndrome Birth Injury Lawyer

  https://www.millerandzois.com/medical-malpractice/birth-injuries/horners-syndrome-birth-injury/

  Horner syndrome, a rare disorder, occurs indiscriminately among all genders and races. Over 65% of all cases of Horners syndrome are related to birth injuries. […] Physical injury or trauma during childbirth is the most common cause of Horners syndrome. Well over half of all Horners syndrome cases are related to birth injuries. […] Horners syndrome is a combination of physical symptoms that appear when the pathway of the sympathetic nerves on one side of the face is disrupted. Usually first seen by a nurse, these characteristic symptoms of Horners syndrome are: Miosis a chronic constriction of the pupil of the affected eye making it appear smaller than the other eyes pupil. Ptosis a persistent drooping of the upper eyelid. Sometimes the lower eyelid may appear elevated (upside-down ptosis). The affected eye may also have a sunken or deep-set appearance compared to the other eye. Lack of normal sweating (anhidrosis) only on the affected side of the face. The pupil of the affected eye may show very little or slow dilation in dim light. In babies under 12 months Horners syndrome may result in one eye having a somewhat lighter color than the other.

• #5 Horner Syndrome: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17836-horners-syndrome

  Horner syndrome is a rare neurological syndrome that affects your eye and the surrounding area on one side of your face. […] Seek medical care if you develop Horner syndrome. […] Symptoms include a drooping upper eyelid, constricted pupil, bloodshot eye and a lack of sweating in the affected area. […] The symptoms associated with Horner syndrome generally dont cause significant issues with your health or vision. However, they can indicate the presence of an underlying health problem that may be very serious. Its important to seek medical care if you develop symptoms of Horner syndrome to determine the underlying cause. […] The treatment for Horner syndrome involves treating the underlying cause. As there are many possible causes, the kinds of treatment can vary widely. […] If you have symptoms of Horner syndrome, such as one drooping upper eyelid, mismatched pupil sizes and lack of sweating on the same side of your face, see a healthcare provider as soon as possible. […] Because of this, its crucial to see a healthcare provider if you develop the syndrome so they can determine the underlying cause and treat it immediately.

• #6 Horner Syndrome – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/autonomic-nervous-system-disorders/horner-syndrome

  Horner syndrome affects one side of the face, causing the eyelid to droop, the pupil to become small (constricted), and sweating to decrease. The cause is disruption of the nerve fibers that connect the brain to the eye. […] Horner syndrome may occur on its own or result from a disorder that disrupts nerve fibers connecting the brain with the eye. […] The upper eyelid droops, the pupil remains small, and the affected side of the face may sweat less. […] The cause, if identified, is treated. […] Horner syndrome can develop in people of any age. […] Symptoms of Horner syndrome include a drooping upper eyelid (ptosis) and a constricted pupil (miosis). […] The affected side of the face may sweat less than normal or not at all, and rarely, it appears flushed. […] Horner syndrome is suspected based on symptoms.

• #7 Horner’s Syndrome, Causes, Symptoms and Treatment

  https://www.birthinjuryguide.org/birth-injury-types/horners-syndrome/

  Horner’s syndrome is a condition caused by damage to the nerve pathway that leads from the brain to the eye and face on the affected side of the body. […] Because Horner’s syndrome is often the result of other injuries, the best way to prevent the condition is to ensure adequate care during pregnancy, labor and delivery. […] Generally, the prognosis for Horner’s syndrome is favorable. Of course, we have noted that the key to treating this condition is treating the underlying cause. To that end, the best way that you, as a parent, can optimize your child’s prognosis is to work closely with his or her healthcare team. Work together to determine the exact cause of your child’s injuries and find treatment options that will benefit his or her overall health.

• #8 Horner Syndrome in Children — Pediatric EM Morsels

  https://pedemmorsels.com/horner-syndrome-in-children/

  Horner Syndrome can be Congenital or Acquired [Cahill, 2015] […] Congenital […] Present in early infancy and persists into early childhood. […] Most common identifiable cause of pediatric Horner Syndrome = Birth Trauma […] Acquired […] Many cases are idiopathic. [Mahoney, 2006] […] Biggest concerns for evaluation of new-onset Horner Syndrome is Neuroblastoma. [Miquel, 2017] […] Children do get Horner Syndrome, but for different reasons than adults. […] Birth Trauma leads the way. Congenital causes are likely to be mechanical stress placed on the neck/carotid sheath. […] New onset Horner Syndrome? Gotta think of neuroblastoma.

• #9 Horner Syndrome – What You Need to Know

  https://www.drugs.com/cg/horner-syndrome.html

  Horner syndrome is a nerve condition that affects one side of your face. The condition is caused by an injury to a nerve that controls that side of the face. Horner syndrome may be a sign of a serious condition such as a stroke or aneurysm. It is important to seek immediate care if you develop other problems, such as head or neck pain. […] Treatment of Horner syndrome depends on the cause. Signs and symptoms usually go away after the cause is treated. You may need any of the following: […] An ophthalmologist (eye specialist) may be able to find and treat vision problems that develop. […] Occupational therapy may be helpful if you have trouble seeing because of eyelid drooping. An occupational therapist can help you strengthen affected eye muscles. The therapist can also help you find ways to do your work or daily activities more easily if you are having vision problems.

• #10 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Horner’s syndrome treatment and management involves diagnosis of the underlying condition and treatment as appropriate. […] Horner’s syndrome associated with pain always needs investigation. If there is arm, shoulder or hand pain think of Pancoast’s syndrome. If pain is in the face or neck, think of carotid dissection. Pain and transient visual loss may be due to carotid dissection. […] In children, unless there is a known aetiology such as birth trauma, acquired Horner’s syndrome requires thorough investigation; there is frequently a serious underlying cause, including neuroblastoma, trauma, rhabdomyosarcoma and brainstem vascular malformation.

• #11 Iatrogenic Horner’s syndrome after insertion of a central venous catheter: recommendations for clinical practice | The Egyptian Journal of Internal Medicine | Full Text

  https://ejim.springeropen.com/articles/10.1186/s43162-022-00144-6

  Horners syndrome is a rare complication of central venous catheter (CVC) insertion. It comprises a triad of unilateral ptosis, ipsilateral meiosis with a normally reactive pupil, and ipsilateral facial anhidrosis of variable spread. […] The patient was counseled regarding the etiology of the disease and advised monthly follow-up. […] Horners syndrome is an uncommon complication that can easily be prevented by corrections in technique and experience. The study emphasizes the establishment of diagnostic and preventive principles for HS. […] The right IJV is the preferred side for CVC insertion because it has predictable anatomy, a high success rate, and a low risk of complications. […] Ways in which a CVC may cause HS include direct damage to the sympathetic chain, direct damage to the peri-subclavian neural loops, and hematoma of associated vasculature.

• #12 UT Health Austin | Horner’s Syndrome

  https://uthealthaustin.org/conditions/horners-syndrome

  A careful eye exam measuring pupil response may be used in addition to other tests to help diagnose Horners syndrome, which can be difficult to identify. […] Treatment depends on which nerve is affected by your condition as well as the underlying cause of your symptoms. […] Your ophthalmologist is well-versed in the most current, evidence-based treatment recommendations, which may include medication, monitoring, or surgery, and will work with you to determine the best course of action. […] At UT Health Austin, we take a multidisciplinary approach to your care. […] Your care team will include fellowship-trained ophthalmologists, ophthalmic technicians, physician assistants, nurse practitioners, social workers, and more who work together to help you get back to the things in your life that matter most to you. […] We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.

• #13 Horner’s syndrome in patients admitted to the intensive care unit that have undergone central venous catheterization: a prospective study | Eye

  https://www.nature.com/articles/eye2015181

  Central venous catheterization (CVC) is estimated to be performed in millions of patients per year. […] This study aims to determine the incidence of Horners syndrome in patients admitted to intensive care unit that have undergone internal jugular CVC insertion during their admission and to determine whether ultrasonography-assisted insertion has decreased the frequency of this complication. […] Horners syndrome remains a relatively rare but definitive complication of CVC. ICU physicians should be educated about its existence and prevalence and ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with Horners syndrome. […] Horners syndrome is an uncommon complication of CVC. […] We conclude that Horners syndrome remains a relatively rare but definitive complication of CVC even in the era of ultrasound-guided insertion and ICU physicians should be educated about its existence and prevalence. Similarly, we recommend that ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with acute Horners syndrome. […] Efforts to minimize and prevent the occurrence of CVC complications should be a routine element of quality improvement programs.

• #14 Horner Syndrome – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/autonomic-nervous-system-disorders/horner-syndrome

  To confirm the diagnosis of Horner syndrome and determine where the problem is, doctors do a two-part test: First, they apply eye drops that contain small amounts of cocaine or another medication (apraclonidine) to both eyes. […] If Horner syndrome is likely, magnetic resonance imaging (MRI) or computed tomography (CT) of the brain, spinal cord, chest, and/or neck is done to look for tumors and other serious disorders that may be disrupting nerve fibers connecting the brain and the eye. […] The cause of Horner syndrome, if identified, is treated. However, there is no specific treatment for Horner syndrome. Often, no treatment is necessary because typically, the eyelid only droops very slightly.

• #15 Horner’s Syndrome Following COVID-19 Infection and Treatment | Published in CRO (Clinical & Refractive Optometry) Journal

  https://clinicaloptometry.scholasticahq.com/article/36745-horner-s-syndrome-following-covid-19-infection-and-treatment

  Horners syndrome occurs secondary to paresis of the oculo-sympathetic pathway and classically presents with the triad of ptosis, miosis, and anhidrosis. […] We will include an overview of the clinical presentation, various etiologies, diagnosis, and management of Horners syndrome. […] Based on the presence of left upper lid ptosis and pupil miosis, diagnostic testing for suspected Horners syndrome was initiated. […] Upon re-evaluation, the ptosis of the left upper lid was almost completely resolved and the previously miotic left pupil was dilated, confirming our suspicion of Horners syndrome. […] When the patient was discharged from the hospital follow-up care was coordinated with his primary care provider who slowly tapered the oral steroids over the following one-month period. […] Improvement of the ptosis and miosis was attributed to the resolution of inflammation.

• #16

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  A 55-year-old hypertensive man complains of acute headache on the left and is found to have a left Horner syndrome. What evaluation is necessary with Horner syndrome and how urgently should it be performed? Are there any life-threatening etiologies of a Horner syndrome? […] He needs to be evaluated emergently in neurology with noninvasive vascular imaging. If a dissection is confirmed, he will need to be admitted and treated to prevent a cerebral infarction. […] All patients need a physical examination (ocular, neurologic, neck, supraclavicular, chest). The tests ordered will vary depending on the lesion location, the presence of associated symptoms or signs, the urgency of the work-up, and the radiologists preference. […] Most patients with Horner syndrome have no visual changes and tolerate a mild ptosis. Rarely, lid surgery is requested to correct a persistent ptosis. Topical apraclonidine corrects the ptosis associated with Horner syndrome and may be used intermittently for cosmetic reasons or when the ptosis reduces the superior visual field.

• #17 Shedding light on Horner syndrome

  https://www.ophthalmologytimes.com/view/shedding-light-on-horner-syndrome

  Horner syndrome is characterized by ipsilateral ptosis, miosis, and anhidrosis that result from a lesion affecting the oculosympathetic pathway. […] It is important to promptly and accurately diagnose the cause; ophthalmologists are likely to be on the front lines. […] We recommend imaging of the oculosympathetic pathway in all cases of Horner syndrome without a clear ethology, even in neurologically isolated cases, particularly when pain is present, Fairbanks emphasized. […] Ophthalmologists should keep in mind that ICA dissections are likely to occur in younger patients, may look like an isolated syndrome or present with neurologic disease and stroke, are painful, and may cause facial paresthesia, blurred vision, or photophobia compared with other causes.

• #18

  https://link.springer.com/article/10.1007/s001340050546

  We present two cases of Horners syndrome occurring following uncomplicated internal jugular venous cannulation. […] An awareness of this potential complication will reduce confusion over the aetiology of anisocoria in critically ill patients. […] This consideration is important, since lesions in the central nervous system or carotid dissection following trauma might otherwise be suspected.

• #19

  https://journals.lww.com/10.1097/TME.0b013e3181da3f43

  Horner syndrome was diagnosed. Horner syndrome refers to a constellation of signs produced when sympathetic innervations to the eye are interrupted. Horner syndrome is a rare condition that affects the nerves to the eye and face. Symptoms included decreased sweating on the affected side of the face, drooping eyelid (ptosis), sinking of the eyeball into the face, and constricted pupil. […] Careful direction of the history to rule out life-threatening disorders is of the utmost importance for advanced practice nurses in the emergency department. […] The causes, management, and outcomes of CAD are discussed herein.

• #20 Case Study: Managing pain in Horner’s syndrome – Oncology Nurse Advisor

  https://www.oncologynurseadvisor.com/home/hot-topics/palliative-care/case-study-managing-pain-in-horners-syndrome/

  Clinical examination identified a right-sided Horners syndrome. […] Horners syndrome describes a range of features associated with interruption of the sympathetic innervation to the eye. […] Signs of the condition include ptosis (drooping of the eyelid), miosis (small pupil), and ipsilateral anhydrosis (impaired sweating on the affected side). […] In palliative care, the importance of regular and systematic review for each patient cannot be overemphasised. […] When patients symptoms fail to respond to established therapies and/or the symptoms and signs change, clinicians must revisit this presumptive diagnosis and search for additional or contributing factors.

• #21 Horner’s Syndrome Following COVID-19 Infection and Treatment | Published in CRO (Clinical & Refractive Optometry) Journal

  https://clinicaloptometry.scholasticahq.com/article/36745-horner-s-syndrome-following-covid-19-infection-and-treatment

  This case outlines the novel presentation of transitory Horners syndrome secondary to cervical and upper chest trauma associated with prolonged intubation for the treatment of respiratory complications from COVID-19 infection. […] This review emphasizes the necessity of a thorough case history, appropriate testing, and interdisciplinary collaboration.

• #22

  https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951369

  Horner’s syndrome is a collection of signs that have significance when they go together. […] Horner’s syndrome consists of five signs: Constricted pupil, Elevated third eyelid, Retraction of the eyeball into the head, Slight drooping of the eyelid, Increased pink color and warmth of the ear and nose on the affected side (very hard to detect in small animals). […] When the sympathetic nerves controlling one of the eyes are damaged, only the parasympathetic nerves work and Horners syndrome is created. […] It is not necessary to treat Horner’s syndrome. The syndrome is not painful and does not interfere with vision. The significance of the syndrome is that it indicates nerve damage that must be recognized. If you wish to treat the syndrome for cosmetic reasons, phenylephrine eye drops can be prescribed to relieve clinical signs. The most important thing is to determine what caused the Horner’s syndrome. Horner’s syndrome itself probably does not need treatment, but its underlying cause very well might.

• #23 All You Need to Know about Horner’s Syndrome in Dogs | Levan Road Veterinary Hospital

  https://levanroadvet.com/blog/horners-syndrome-in-dogs/

  Horners Syndrome is a neurological disorder affecting the eyes and muscles of the face in dogs. This condition can make one side of your dogs face appear different from the other. You might notice symptoms like a droopy eyelid, a smaller pupil, or even an ear that seems to be sagging on one side. […] If you observe these symptoms in your dog, its essential to contact Levan Road Veterinary Hospital for a thorough examination. […] Detecting the root cause is crucial for effective treatment, highlighting the importance of professional veterinary care. […] The treatment for Horners Syndrome depends on its underlying cause. If an infection is at fault, antibiotics might be necessary. For more severe causes like tumors, treatment could involve surgery or other specialized care. In some cases, Horners Syndrome might resolve on its own, but monitoring by a vet is always recommended to ensure your dogs health and comfort.

• #24 Iatrogenic Horner’s syndrome after insertion of a central venous catheter: recommendations for clinical practice | The Egyptian Journal of Internal Medicine | Full Text

  https://ejim.springeropen.com/articles/10.1186/s43162-022-00144-6

  Clinical features of HS include ptosis (with or without reverse ptosis) and meiosis (more apparent in darkness), which occur due to paresis of muller and dilator pupillae muscles, respectively. […] Once HS is diagnosed and attributed to catheter insertion; the CVC should be removed by a specialist to limit further damage. […] Conclusively, Horner syndrome is an uncommon complication of a common procedure, CVC insertion, that can easily be prevented with experience and correction in technique. The study also emphasizes the establishment of diagnostic and preventive principles for HS.

• #25 Horner Syndrome – What You Need to Know

  https://www.drugs.com/cg/horner-syndrome.html

  Surgery or medication may be used if you have severe eyelid drooping. […] You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

• #26 Horner Syndrome in Children – What You Need to Know

  https://www.drugs.com/cg/horner-syndrome-in-children.html

  Horner syndrome is a nerve condition that affects one side of your child’s face. The condition is caused by an injury to a nerve that controls that side of the face. Your child may have developed Horner syndrome during birth. Horner syndrome may be a sign of a serious condition such as a stroke or aneurysm. It is important to seek immediate care if your child develops other problems, such as head or neck pain. […] Treatment of Horner syndrome depends on the cause. Signs and symptoms usually go away if the cause can be treated. Your child may need any of the following: […] An ophthalmologist (eye specialist) may be able to find and treat vision problems that develop. Your child’s vision may not develop normally if the eyelid drooping is severe. […] Occupational therapy may be helpful if your child has trouble seeing because of eyelid drooping. An occupational therapist can help your child strengthen affected eye muscles. The therapist can also help your child find ways to do school or daily activities more easily if he or she has vision problems.

• #27 All You Need to Know about Horner’s Syndrome in Dogs | Levan Road Veterinary Hospital

  https://levanroadvet.com/blog/horners-syndrome-in-dogs/

  Supporting your dog through their treatment involves keeping them comfortable and following your vets advice closely. Regular check-ups are essential to monitor their progress and adjust treatment as needed. […] Early detection and treatment can make a big difference in managing Horners Syndrome. Prompt veterinary care ensures your dog receives the necessary treatment to alleviate symptoms and address the underlying cause.

• #28 Horner Syndrome Following Attempted Internal Jugular Catheter Placement in a Toddler With Congenital Heart Disease | Tobias | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/1795/1162

  Horner syndrome results from interruption of the normal sympathetic innervation to the face and eye. Common clinical manifestations include ptosis, miosis, anhidrosis, conjunctival injection and relative enophthalmos. […] Treatment involves general supportive care; however, imaging may be indicated if there is a question regarding the etiology. […] Most importantly, prevention remains the primary intervention in such cases. […] Given the proximity of structures within the neck especially in a child, we would highly recommend the use of ultrasound to facilitate central venous catheter placement. […] An appropriate diagnosis may limit the need for unnecessary imaging; however, if the etiology is in doubt, imaging is suggested to identify pathologic lesions along the sympathetic pathway.

• #29 Horner Syndrome in Children – What You Need to Know

  https://www.drugs.com/cg/horner-syndrome-in-children.html

  Surgery or medication may be used if your child has severe eyelid drooping. […] You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s healthcare providers to decide what care you want for your child.

• #30 Frontiers | Horner’s Syndrome as Initial Manifestation of Possible Brachial Plexopathy Neurolymphomatosis

  https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00004/full

  Horner’s syndrome is an established clinical finding unique to neoplastic brachial plexopathy. […] The presence of Horner’s syndrome in brachial plexopathy of indeterminate etiology, even in the absence of bulky adenopathy, should raise clinical suspicion of NL, possibly prompting such interventions as fascicular nerve biopsy. […] Although preliminary testing may be negative or inconclusive, the presence of unexplained Horner’s syndrome in the setting of unexplained brachial plexopathy should prompt consideration for fascicular nerve biopsy testing to evaluate for NL. Unique to our case is that such a Horner’s syndrome occurred in the absence of bulky adenopathy, as is typical with Pancoast Syndrome.

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