Materiały źródłowe

• #1 Horner Syndrome – StatPearls – NCBI Bookshelf

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

  Horner syndrome is uncommon, occurring with a frequency of approximately 1 per 6,000. It may occur at any age or with any ethnic group.

• #2 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Horner syndrome has a frequency of 1 per 6,250 population. It may occur at any age and in any ethnicity. […] Horner syndrome is uncommon. No age, sexual, or racial predilections are known to exist. The prognosis and the complications to be expected depend on the underlying cause of the syndrome, as does treatment.

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

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

  Horner syndrome is uncommon. It affects approximately 1 in 6,000 people. […] Horner syndrome can affect anyone at any age. About 5% of people with the condition have the congenital form (present from birth). […] The prognosis (outlook) of Horner syndrome depends on the underlying cause. The characteristic symptoms of Horner syndrome generally dont have a significant impact on your quality of life or vision.

• #4 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Horner syndrome has a frequency of 1 per 6,250 population. It may occur at any age and in any ethnicity. […] Horner syndrome is uncommon. No age, sexual, or racial predilections are known to exist. The prognosis and the complications to be expected depend on the underlying cause of the syndrome, as does treatment.

• #5 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. […] Horners syndrome occurs in approximately 1 per 6,000 people worldwide making it an uncommon condition. […] Horners syndrome affects males and females equally, and it may occur at any age affecting both pediatric and elderly populations. […] There is no predilection for Horners syndrome in any geographic location or in any ethnic group. […] Confirmation of suspected Horners syndrome can be achieved with ophthalmic pharmacological testing. […] Once the diagnosis of Horners syndrome is confirmed with ophthalmic pharmacological testing, it is important to uncover the underlying cause in a timely manner, as certain etiologies of Horners syndrome can prove fatal if untreated.

• #6 Horner Syndrome | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117605/all/Horner_Syndrome

  Estimated incidence of pediatric Horner syndrome is 1.42 per 100,000 in patients 19 years of age with a birth prevalence of 1 in 6,250 for those with congenital onset of Horner syndrome. […] Incidence in adults is not known.

• #7 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Horner’s syndrome (also called oculosympathetic paresis, or Horner syndrome) comprises a constellation of clinical signs including the classic triad of ptosis, miosis, and anhidrosis. It results from a lesion to the sympathetic pathway that supplies the head and neck region. The cause of Horner’s syndrome varies with the site of the lesion. Prompt evaluation is necessary to detect and treat potentially life-threatening conditions. […] In a population based study of Horner’s syndrome in the pediatric age group, the incidence of Horner’s syndrome was estimated to be 1.42 per 100 000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. […] The etiology of Horner’s syndrome varies with the patient age and site of lesion. The etiology remains unknown in 35-40% of cases.

• #8

  https://link.springer.com/article/10.1007/s00415-020-10270-2

  To determine age- and sex-specific incidence and possible etiologies of pediatric and adult Horner syndrome in South Korea. […] A total of 139 pediatric patients (59.7% male) and 1331 adults (51.0% male) were newly diagnosed as having Horner syndrome. The cumulative incidence was 2.12 (95% CI 2.08-2.17) per 100,000 pediatric population and 2.95 (2.94-2.96) per 100,000 adults. […] This study determined the estimated incidence and possible causes of pediatric and adult Horner syndrome.

• #9 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. […] No definitive information is available about the pathologies associated with Horner syndrome and the incidence rate in US adults is unknown, according to Aaron M. Fairbanks, MD, a senior ophthalmology resident at Mayo Clinic, Rochester, Minnesota. […] Because no US population-based studies of the syndrome had been undertaken, Fairbanks and his colleagues set out to determine its population-based incidence in adults, evaluate the underlying causes and disease manifestations, and investigate the value of imaging in patients with a neurologically isolated Horner syndrome. […] The age- and sex-adjusted incidence of Horner syndrome during the study period was 4.24/100,000/year with no difference in gender or over time.

• #10 Horner Syndrome Symptoms, Causes, Treatment | OBN

  https://ophthalmologybreakingnews.com/ophthalmologynews-horner-syndrome

  During the study period, the age- and sex-adjusted incidence of Horner syndrome was 4.24/100,000/year, with no variation by gender or across time. […] The researchers noted that there was a substantial difference between age groups, with older patients having a higher incidence of Horner syndrome.

• #11 Horner Syndrome Symptoms, Causes, Treatment | OBN

  https://ophthalmologybreakingnews.com/ophthalmologynews-horner-syndrome

  During the study period, the age- and sex-adjusted incidence of Horner syndrome was 4.24/100,000/year, with no variation by gender or across time. […] The researchers noted that there was a substantial difference between age groups, with older patients having a higher incidence of Horner syndrome.

• #12 Horner syndrome | MedLink Neurology

  https://www.medlink.com/articles/horner-syndrome

  A robust claims database study of patients with Horner syndrome diagnosed between 2009 and 2018 in Korea disclosed 1331 cases in adults and 139 cases in children. The annual incidence in adults was 0.39 out of 100,000; in children, it was 0.20 out of 100,000. Peak age at diagnosis in adults was between ages 50 and 54; in children, it was before age 4. No cause was found in 43% of cases. Where a cause was found, it had been evident in 92% of cases by the time the Horner syndrome was recognized. Prominent among the causes identified after the diagnosis of Horner syndrome were neuroblastic tumors in children and thyroid tumors in adults. In an epidemiologic study of Horner syndrome in 20 children living in Olmsted County, Minnesota, the age-adjusted and sex-adjusted incidence was 1.42 per 100,000. Eleven cases were caused by birth trauma, a birth prevalence of 1 in 6250.

• #13 Horner’s Syndrome – All About Vision

  https://www.allaboutvision.com/conditions/related/horners-syndrome/

  Horners syndrome is a rare disorder that affects the eye and nearby tissue on one side of the face. This disorder affects males and females equally and can happen in any age group, ethnic group or geographic location. […] Some cases of Horner syndrome occur for no apparent reason, according to the National Organization for Rare Disorders. In other cases, the disorder may be genetically inherited. […] Fewer than 5% of cases of this disorder are classified as congenital Horners syndrome. […] Most cases of congenital Horners syndrome result from damage to nerves known as the cervical sympathetics. […] An eye doctor may be able to confirm Horners syndrome with a special eye test. Furthermore, tests may be needed to pinpoint the cause. […] If a child is diagnosed with Horners syndrome, the doctor may order more tests, such as X-rays or urine tests, to find out whether the patient has neuroblastoma or any abnormalities in the abdomen, brain, chest or neck.

• #14

  https://journals.lww.com/ijo/fulltext/2006/54030/congenital_horner_s_syndrome_and_the_usefulness_of.11.aspx

  Horner’s syndrome (HS) or oculosympathoparesis classically presents with ipsilateral ptosis, miosis of the pupil and facial anhidrosis. […] Congenital HS is most commonly idiopathic or due to birth trauma. […] It has been estimated that less than 5% of HS can be classified as congenital. […] In a pediatric population with HS, Jeffery et al. reported that 42% were congenital, 15% were acquired without surgical intervention and 42% were acquired after a surgical procedure of the thorax, neck or central nervous system. […] As a result of history, clinical examination, pharmacological testing and neuroimaging, we assumed that HS in this baby was congenital. […] Delivery-related brachial plexus injury is known as the most common cause of HS. However, any lesion along the sympathetic chain may result in HS. […] In conclusion, although delivery-related brachial plexus injury is known as the most common cause of congenital HS, imaging of the entire sympathetic pathway is warranted, since life-threatening malignancy and abnormalities may be revealed.

• #15 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Horner’s syndrome (also called oculosympathetic paresis, or Horner syndrome) comprises a constellation of clinical signs including the classic triad of ptosis, miosis, and anhidrosis. It results from a lesion to the sympathetic pathway that supplies the head and neck region. The cause of Horner’s syndrome varies with the site of the lesion. Prompt evaluation is necessary to detect and treat potentially life-threatening conditions. […] In a population based study of Horner’s syndrome in the pediatric age group, the incidence of Horner’s syndrome was estimated to be 1.42 per 100 000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. […] The etiology of Horner’s syndrome varies with the patient age and site of lesion. The etiology remains unknown in 35-40% of cases.

• #16 Horner syndrome: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/horner-syndrome/

  About 1 in 6,250 babies are born with Horner syndrome. The incidence of Horner syndrome that appears later is unknown, but it is considered an uncommon disorder. […] Horner syndrome is usually not inherited and occurs in individuals with no history of the disorder in their family. Acquired Horner syndrome and most cases of congenital Horner syndrome have nongenetic causes. Rarely, congenital Horner syndrome is passed down within a family in a pattern that appears to be autosomal dominant, which means one copy of an altered gene in each cell is sufficient to cause the disorder. However, no genes associated with Horner syndrome have been identified.

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

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

  Horner syndrome is uncommon. It affects approximately 1 in 6,000 people. […] Horner syndrome can affect anyone at any age. About 5% of people with the condition have the congenital form (present from birth). […] The prognosis (outlook) of Horner syndrome depends on the underlying cause. The characteristic symptoms of Horner syndrome generally dont have a significant impact on your quality of life or vision.

• #18 Horner Syndrome in Children — Pediatric EM Morsels

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

  Horner Syndrome can be Congenital or Acquired [Cahill, 2015] […] Most common identifiable cause of pediatric Horner Syndrome = Birth Trauma […] New onset Horner Syndrome? Gotta think of neuroblastoma.

• #19 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. It is considered a rare condition, affecting only 1.42 out every 100,000 people under the age of 19. […] Around one in every 6,250 cases of Horner’s syndrome happen at birth, and 65 percent of the cases are from birth injuries or trauma. […] 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. Talk to your doctor about any risk factors you have that could lead to complications or birth injuries.

• #20 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Horner’s syndrome (also called oculosympathetic paresis, or Horner syndrome) comprises a constellation of clinical signs including the classic triad of ptosis, miosis, and anhidrosis. It results from a lesion to the sympathetic pathway that supplies the head and neck region. The cause of Horner’s syndrome varies with the site of the lesion. Prompt evaluation is necessary to detect and treat potentially life-threatening conditions. […] In a population based study of Horner’s syndrome in the pediatric age group, the incidence of Horner’s syndrome was estimated to be 1.42 per 100 000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. […] The etiology of Horner’s syndrome varies with the patient age and site of lesion. The etiology remains unknown in 35-40% of cases.

• #21 Horner’s Syndrome: Signs, Causes & Treatment – NVISION

  https://www.nvisioncenters.com/conditions/horners-syndrome/

  Horners syndrome is considered rare. It only impacts about 1 out of every 6,000 people and can occur in people of all ages, genders, and ethnic groups. […] Typically, Horners syndrome is caused by something that interferes with one of the three sympathetic nerve pathways supporting the eye. This can include an accident, injury, trauma, insect or snake bite, illness, or certain cancers. […] In about 35 to 40 percent of cases, the cause of Horners syndrome is unknown. This is often called idiopathic Horner syndrome. […] Horners syndrome is often not very noticeable and commonly goes undetected. There are several methods for diagnosing the disorder even with mild symptoms. […] Horners syndrome is usually caused by damage or disruption to the sympathetic nerve pathways that serve the eye, which can include trauma or medical conditions. It can more rarely be congenital. […] Horners syndrome is typically mild and does not often impair your physical health or vision dramatically. It can, however, be indicative of an underlying and serious medical condition that can be life-threatening.

• #22 Traumatic Horner Syndrome – EyeWiki

  https://eyewiki.org/Traumatic_Horner_Syndrome

  Horner syndrome, known classically by its presenting triad of miosis (pupillary constriction), eyelid ptosis (drooping), and facial anhidrosis (decreased sweating), results from damage to the sympathetic pathways between the hypothalamus and ocular adnexa. […] Although Horner syndrome can result from a variety of mechanisms, the most common etiologies are neoplastic (35-60% of all cases). Other less common causes include iatrogenic injury (10-18.5%) and trauma (4-13% inclusive of birth-related injuries). […] Horner syndrome results from disruption of the oculosympathetic pathways, and is associated with ptosis, miosis, and anhidrosis, although patients may not present with this complete triad. Although there are many causes of Horner syndrome, head, neck, and chest trauma can precipitate the syndrome. Of note, carotid artery dissection, particularly in the setting of trauma, should be considered an emergency.

• #23 Traumatic Horner Syndrome – EyeWiki

  https://eyewiki.org/Traumatic_Horner_Syndrome

  Horner syndrome, known classically by its presenting triad of miosis (pupillary constriction), eyelid ptosis (drooping), and facial anhidrosis (decreased sweating), results from damage to the sympathetic pathways between the hypothalamus and ocular adnexa. […] Although Horner syndrome can result from a variety of mechanisms, the most common etiologies are neoplastic (35-60% of all cases). Other less common causes include iatrogenic injury (10-18.5%) and trauma (4-13% inclusive of birth-related injuries). […] Horner syndrome results from disruption of the oculosympathetic pathways, and is associated with ptosis, miosis, and anhidrosis, although patients may not present with this complete triad. Although there are many causes of Horner syndrome, head, neck, and chest trauma can precipitate the syndrome. Of note, carotid artery dissection, particularly in the setting of trauma, should be considered an emergency.

• #24 Traumatic Horner Syndrome – EyeWiki

  https://eyewiki.org/Traumatic_Horner_Syndrome

  Horner syndrome, known classically by its presenting triad of miosis (pupillary constriction), eyelid ptosis (drooping), and facial anhidrosis (decreased sweating), results from damage to the sympathetic pathways between the hypothalamus and ocular adnexa. […] Although Horner syndrome can result from a variety of mechanisms, the most common etiologies are neoplastic (35-60% of all cases). Other less common causes include iatrogenic injury (10-18.5%) and trauma (4-13% inclusive of birth-related injuries). […] Horner syndrome results from disruption of the oculosympathetic pathways, and is associated with ptosis, miosis, and anhidrosis, although patients may not present with this complete triad. Although there are many causes of Horner syndrome, head, neck, and chest trauma can precipitate the syndrome. Of note, carotid artery dissection, particularly in the setting of trauma, should be considered an emergency.

• #25

  https://link.springer.com/article/10.1007/s00381-020-04966-z

  Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. […] The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL. […] Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. […] HS occurred more frequently in patients with mediastinum tumors. […] As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. […] All of the patients with HS were younger than 2 years old. […] Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. […] However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment. […] Eight cases of HS were found in the whole group (6.72%), representing an incidence of 7.41% among patients with NBL.

• #26

  https://link.springer.com/article/10.1007/s00381-020-04966-z

  Three of them had HS as the presenting symptom (2.78%), while one patient had isolated HS as the only manifestation of NBL (0.93%). […] In this group, there was one patient with congenital HS (0.93%). […] As a presenting symptom, HS occurred in 2 of 11 patients with tumors localized in the mediastinum (18.18%). […] Another four patients were diagnosed with HS after surgery (3.70%), meaning that ptosis or miosis was a complication of the surgical procedure. […] The results are shown in Table 1. […] According to research by Graef et al., development of HS during the course of NBL is associated with a better prognosis. […] In conclusion, investigation of the cause of HS is crucial and requires vigilance and appropriate imaging, as it can be the first or isolated manifestation of neuroblastoma. […] Moreover, the surgical procedures involved in the tumor treatment process significantly increase the incidence of ptosis and miosis.

• #27 Shedding light on Horner syndrome

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

  In this first US population-based study of the incidence of Horner syndrome, the primary take-home points are that 56.4% of cases resulted from a dangerous cause; in previous reports the percentages ranged from 8% to 78%. […] Another finding useful in diagnosis is that about 40% of patients with an isolated Horner syndrome had positive CT or MRI findings, which is almost double that reported previously.

• #28 Shedding light on Horner’s syndrome

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

  Investigators found that 56.4% of Horners syndrome cases resulted from a dangerous cause. […] According to Dr Aaron M. Fairbanks, a senior ophthalmology resident at Mayo Clinic, Rochester, Minnesota, United States, no definitive information is available about the pathologies associated with Horners syndrome and the incidence rate in US adults is unknown. […] In this first US population-based study of the incidence of Horners syndrome, the primary take-home point is that 56.4% of cases resulted from a dangerous cause; in previous reports the percentages ranged from 8% to 78%. […] We recommend imaging of the oculosympathetic pathway in all cases of Horners syndrome without a clear aetiology, even in neurologically isolated cases, particularly when pain is present, Dr Fairbanks emphasised.

• #29 Shedding light on Horner’s syndrome

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

  Investigators found that 56.4% of Horners syndrome cases resulted from a dangerous cause. […] According to Dr Aaron M. Fairbanks, a senior ophthalmology resident at Mayo Clinic, Rochester, Minnesota, United States, no definitive information is available about the pathologies associated with Horners syndrome and the incidence rate in US adults is unknown. […] In this first US population-based study of the incidence of Horners syndrome, the primary take-home point is that 56.4% of cases resulted from a dangerous cause; in previous reports the percentages ranged from 8% to 78%. […] We recommend imaging of the oculosympathetic pathway in all cases of Horners syndrome without a clear aetiology, even in neurologically isolated cases, particularly when pain is present, Dr Fairbanks emphasised.

• #30

  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? […] This patient with an acute isolated painful Horner syndrome is considered to have a left internal carotid artery dissection until proven otherwise. 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. […] Except for rare emergencies, pharmacologic localization of the lesion should ideally be performed before obtaining any neuroimaging in adults. The evaluation of an adult with Horner syndrome is mostly based on lesion location. The most classic cause of central (first-order neuron) Horner is a lateral medullary infarction (Wallenberg syndrome); other causes include various thalamic, brainstem, and spinal cord lesions. Second-order Horner syndromes are most suggestive of neoplasm or trauma of the lower cervical spine, brachial plexus, or lung apex. Third-order Horner syndromes point to lesions of the internal carotid artery such as dissection or cavernous sinus aneurysms. Further evaluation depends upon the duration of symptoms, the presence of pain, other symptoms or signs, and the localization of the lesion to the first- or second-order neuron or to the third-order neuron.

• #31 Horner’s syndrome – Case-Based Neuro-Ophthalmology

  https://pressbooks.pub/casebasedneuroophthalmology/chapter/horners-syndrome/

  The differential diagnosis for this situation includes Horners syndrome (oculosympathetic paresis) […] The signs of Horners syndrome include ptosis of the upper and lower eyelids (the upper lid is at lower position and the lower lid is a higher position), miosis and dilation lag. […] Carotid artery dissection can disrupt the sympathetic fibers ascending around the wall of the internal carotid artery leading to an ipsilateral Horners syndrome. […] Carotid dissection must be ruled out in a patient with an acute Horners syndrome and neck or facial pain. […] The patient had a CTA of the head and neck and a right carotid artery dissection was seen (red arrow). […] Final diagnosis: Right Horners syndrome secondary to a right internal carotid artery dissection. […] Acquired Horners syndrome in a child may be the presenting sign of neuroblastoma, which is a malignant neuroendocrine tumor of the sympathetic nervous system.

• #32 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. […] Frequency of Horners syndrome after CVC was 2% in a sample of 100 prospectively examined patients. […] 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. […] Incidence of Horners syndrome in our population was 2%. […] 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.

• #33 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. […] HS is one of the rarest complications of CVC insertion. […] The incidence of HS due to CVC is reported to be 2% by Butty et al. in his prospective study. […] 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. […] Here, we enlist the following recommendations to reduce the likelihood of developing HS after CVC: A CVC should be inserted under the guidance of direct ultrasound, as it has been shown to reduce the likelihood of developing HS. […] Conclusively, Horner syndrome is an uncommon complication of a common procedure, CVC insertion, that can easily be prevented with experience and correction in technique.

• #34 Horner syndrome after epidural analgesia for labor. Report on three cases | Colombian Journal of Anesthesiology

  https://www.elsevier.es/es-revista-colombian-journal-anesthesiology-342-articulo-horner-syndrome-after-epidural-analgesia-S2256208716000110

  Horner syndrome was first described in 1879 by Swiss ophthalmologist Johann Friedrich Horner. It is characterized by the presence of myosis, ptosis, and anhidrosis, with or without enophthalmos. Its primary cause is the ipsilateral interruption of the sympathetic nerve fibers that innervate the pupil, the upper eyelid lifter muscle, and the facial region. […] Epidural analgesia is considered the analgesic technique of choice for labor. Horner syndrome associated with epidural analgesia for labor was described by Kepes in 1972. Its incidence is estimated at between 0.4 and 4%. […] The clinical presentation of Horner syndrome is inconspicuous and can go unnoticed, with some authors affirming that it can go unobserved in 75% of births by cesarean section that use this anesthetic method. […] The presentation of Horner syndrome is, in most cases, self-limiting and resolves itself in an average time of 215min, with a relatively benign course.

• #35 Transient Ipsilateral Horner’s Syndrome after Ultrasound Guided Interscalene Brachial Plexus Nerve Block

  http://clinmedjournals.org/articles/cmil/cmil-9-223.php?jid=cmil

  Horner’s Syndrome consists of the set of signs and symptoms which manifest due to the blockade of the ipsilateral sympathetic pathway that innervates head, face and eye. It mainly presents with the triad of ptosis, miosis and anhidrosis. […] Various studies have reported occurrence of Horner syndrome after interscalene brachial plexus block to be between 4-37.5% depending upon block technique, drug volume, concentration, and mode of delivery like a single bolus injection or a continuous infusion.

• #36

  https://biomedres.us/fulltexts/BJSTR.MS.ID.006866.php

  The incidence of Horner syndrome is low after surgery for differentiated thyroid cancer as reported by very rare cases. A total of 18 cases of Horner syndrome after thyroid surgery have been reported in China and abroad since 1993, according to Meng et al. […] Horner syndrome caused by thyroid surgery is a type of postganglionic lesions, which is relatively rare. […] Horner syndrome can be caused by surgery in the cervical sympathetic nerve course, which generally occurs at the thoracic entrance and upper mediastinum surgery, and rarely in thyroid surgery. […] There is a low incidence of Horner syndrome after surgery for differentiated thyroid cancer.

• #37 Shedding light on Horner syndrome

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

  In this first US population-based study of the incidence of Horner syndrome, the primary take-home points are that 56.4% of cases resulted from a dangerous cause; in previous reports the percentages ranged from 8% to 78%. […] Another finding useful in diagnosis is that about 40% of patients with an isolated Horner syndrome had positive CT or MRI findings, which is almost double that reported previously.

• #38

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

  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. If a first- or second order Horner is present, I suggest computed tomography (CT) or magnetic resonance imaging (MRI) of the chest (to view pulmonary apex), MRI head and neck with contrast, and possibly a magnetic resonance angiography (MRA) of the aortic arch or CTA (CT angiogram) of the head and neck. If a third-order Horner is present, I suggest MRI of the head with contrast and MRA or CTA of the head and neck. If localization of the Horner syndrome is unknown, I suggest imaging the brain, neck, spinal cord, carotid arteries, and pulmonary apex (may require multiple imaging tests).

• #39

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

  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. If a first- or second order Horner is present, I suggest computed tomography (CT) or magnetic resonance imaging (MRI) of the chest (to view pulmonary apex), MRI head and neck with contrast, and possibly a magnetic resonance angiography (MRA) of the aortic arch or CTA (CT angiogram) of the head and neck. If a third-order Horner is present, I suggest MRI of the head with contrast and MRA or CTA of the head and neck. If localization of the Horner syndrome is unknown, I suggest imaging the brain, neck, spinal cord, carotid arteries, and pulmonary apex (may require multiple imaging tests).

• #40

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

  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. If a first- or second order Horner is present, I suggest computed tomography (CT) or magnetic resonance imaging (MRI) of the chest (to view pulmonary apex), MRI head and neck with contrast, and possibly a magnetic resonance angiography (MRA) of the aortic arch or CTA (CT angiogram) of the head and neck. If a third-order Horner is present, I suggest MRI of the head with contrast and MRA or CTA of the head and neck. If localization of the Horner syndrome is unknown, I suggest imaging the brain, neck, spinal cord, carotid arteries, and pulmonary apex (may require multiple imaging tests).

• #41 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. […] Horners syndrome occurs in approximately 1 per 6,000 people worldwide making it an uncommon condition. […] Horners syndrome affects males and females equally, and it may occur at any age affecting both pediatric and elderly populations. […] There is no predilection for Horners syndrome in any geographic location or in any ethnic group. […] Confirmation of suspected Horners syndrome can be achieved with ophthalmic pharmacological testing. […] Once the diagnosis of Horners syndrome is confirmed with ophthalmic pharmacological testing, it is important to uncover the underlying cause in a timely manner, as certain etiologies of Horners syndrome can prove fatal if untreated.

• #42

  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? […] This patient with an acute isolated painful Horner syndrome is considered to have a left internal carotid artery dissection until proven otherwise. 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. […] Except for rare emergencies, pharmacologic localization of the lesion should ideally be performed before obtaining any neuroimaging in adults. The evaluation of an adult with Horner syndrome is mostly based on lesion location. The most classic cause of central (first-order neuron) Horner is a lateral medullary infarction (Wallenberg syndrome); other causes include various thalamic, brainstem, and spinal cord lesions. Second-order Horner syndromes are most suggestive of neoplasm or trauma of the lower cervical spine, brachial plexus, or lung apex. Third-order Horner syndromes point to lesions of the internal carotid artery such as dissection or cavernous sinus aneurysms. Further evaluation depends upon the duration of symptoms, the presence of pain, other symptoms or signs, and the localization of the lesion to the first- or second-order neuron or to the third-order neuron.

• #43 The Radiology Assistant : Horner syndrome.

  https://radiologyassistant.nl/neuroradiology/horners-syndrome

  Horner syndrome is a rare clinical condition presenting with partial ptosis, miosis and facial anhidrosis described in 1869 by Johann Friedrich Horner. […] Imaging plays an important role in the final diagnosis. […] Clinically it can be difficult to differentiate a central Horner from a pre- or postganglionic Horner. Pharmacological testing of the eyes with Apraclonidine or Cocaine can help make the diagnosis. […] Pre- and postganglionic causes of Horner syndrome are as common. Central Horner syndrome is uncommon. Clinically frequently the central Horner syndrome goes unnoticed, because the other symptoms of brain pathology dominate the clinical picture. […] Preganglionic Horner syndrome is a common cause of Horner syndrome and most often caused by tumor or trauma. […] Postganglionic causes of Horner are as common compared as preganglionic. […] An acute isolated Horner syndrome with headache or neck pain is a carotid dissection until proven otherwise and MRA or CTA of the head and neck is needed.

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

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

  Horner’s syndrome is an uncommon condition, with a frequency of 1 in 6,000. It has no predilection for age, sex or race. […] 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.

• #45

  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? […] This patient with an acute isolated painful Horner syndrome is considered to have a left internal carotid artery dissection until proven otherwise. 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. […] Except for rare emergencies, pharmacologic localization of the lesion should ideally be performed before obtaining any neuroimaging in adults. The evaluation of an adult with Horner syndrome is mostly based on lesion location. The most classic cause of central (first-order neuron) Horner is a lateral medullary infarction (Wallenberg syndrome); other causes include various thalamic, brainstem, and spinal cord lesions. Second-order Horner syndromes are most suggestive of neoplasm or trauma of the lower cervical spine, brachial plexus, or lung apex. Third-order Horner syndromes point to lesions of the internal carotid artery such as dissection or cavernous sinus aneurysms. Further evaluation depends upon the duration of symptoms, the presence of pain, other symptoms or signs, and the localization of the lesion to the first- or second-order neuron or to the third-order neuron.

• #46 Shedding light on Horner’s syndrome

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

  Investigators found that 56.4% of Horners syndrome cases resulted from a dangerous cause. […] According to Dr Aaron M. Fairbanks, a senior ophthalmology resident at Mayo Clinic, Rochester, Minnesota, United States, no definitive information is available about the pathologies associated with Horners syndrome and the incidence rate in US adults is unknown. […] In this first US population-based study of the incidence of Horners syndrome, the primary take-home point is that 56.4% of cases resulted from a dangerous cause; in previous reports the percentages ranged from 8% to 78%. […] We recommend imaging of the oculosympathetic pathway in all cases of Horners syndrome without a clear aetiology, even in neurologically isolated cases, particularly when pain is present, Dr Fairbanks emphasised.

• #47 Top Published Expert Doctors for Horner Syndrome

  https://www.findexpertmd.com/d/Horner_Syndrome

  334 top medical experts on Horner Syndrome across 40 countries and 30 U.S. states, including 226 MDs (Physicians). This is based on an objective analysis of their Scientific Publications, Clinical Trials, Medicare, and NIH Grants. […] Clinical Trials ClinicalTrials.gov: at least 6 including 3 Completed, 1 Recruiting.

• #48 Top Published Expert Doctors for Horner Syndrome

  https://www.findexpertmd.com/d/Horner_Syndrome

  334 top medical experts on Horner Syndrome across 40 countries and 30 U.S. states, including 226 MDs (Physicians). This is based on an objective analysis of their Scientific Publications, Clinical Trials, Medicare, and NIH Grants. […] Clinical Trials ClinicalTrials.gov: at least 6 including 3 Completed, 1 Recruiting.

• #49 Horner syndrome after epidural analgesia for labor. Report on three cases | Colombian Journal of Anesthesiology

  https://www.elsevier.es/es-revista-colombian-journal-anesthesiology-342-articulo-horner-syndrome-after-epidural-analgesia-S2256208716000110

  Therefore, surveillance of the patient is essential, especially if we opt to maintain the epidural catheter. […] The majority of the series described in the literature are isolated cases. Few case series affecting multiple patients have been published. The main reason for this is probably the low degree of suspicion and the underdiagnosis of the syndrome—in other words, it has to be actively looked for. Despite its favorable prognosis, it can directly indicate a cephalic spread of local anesthetic to potentially dangerous levels. Therefore, observation and surveillance until the complete disappearance of the clinical presentation, along with suspension of perfusion of local anesthetic, are essential to its management.

• #50 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. […] Frequency of Horners syndrome after CVC was 2% in a sample of 100 prospectively examined patients. […] 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. […] Incidence of Horners syndrome in our population was 2%. […] 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.

• #51 Horner Syndrome: A Rare Complication of Cervical and Thoracic Herpes Zoster Infection | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-horner-syndrome-a-rare-complication-articulo-S1578219015001791

  Horner syndrome (miosis, ptosis, enophthalmos, and/or anhidrosis) is a rare complication of cervical and thoracic herpes zoster. […] Our search of the literature for herpes zoster associated with Horner syndrome revealed 11 reported cases of patients aged 24 to 79 years, including 7 men and 4 women. Horner syndrome was associated with herpes zoster involvement of branches of the fifth cranial nerve in 5 cases, and with involvement of cervical and/or thoracic dermatomes in 6 cases. […] In our view, early antiviral treatment, whether oral or intravenous, reduces the risk of persistence over weeks or years.

• #52 Nationwide population-based incidence and etiologies of pediatric and adult Horner syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33090271/

  Purpose: To determine age- and sex-specific incidence and possible etiologies of pediatric and adult Horner syndrome in South Korea. […] A total of 139 pediatric patients (59.7% male) and 1331 adults (51.0% male) were newly diagnosed as having Horner syndrome. The cumulative incidence was 2.12 (95% CI 2.08-2.17) per 100,000 pediatric population and 2.95 (2.94-2.96) per 100,000 adults. […] This study determined the estimated incidence and possible causes of pediatric and adult Horner syndrome. As Horner syndrome with unknown etiologies may harbor serious malignancy, extensive evaluations are required, especially in children.

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