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Horner Syndrome (Horner's Syndrome)

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A syndrome associated with defective sympathetic innervation to one side of the face, including the eye. Clinical features include MIOSIS; mild BLEPHAROPTOSIS; and hemifacial ANHIDROSIS (decreased sweating)(see HYPOHIDROSIS). Lesions of the BRAIN STEM; cervical SPINAL CORD; first thoracic nerve root; apex of the LUNG; CAROTID ARTERY; CAVERNOUS SINUS; and apex of the ORBIT may cause this condition. (From Miller et al., Clinical Neuro-Ophthalmology, 4th ed, pp500-11)

Also Known As:

Horner's Syndrome; Syndrome, Horner's; Syndrome, Horner; Bernard Syndrome; Bernard's Syndrome; Claude Bernard-Horner Syndrome; Horner Syndrome, Acquired; Horner Syndrome, Central; Horner's Syndrome, Pupil; Ophthalmoplegia, Sympathetic Ocular; Ptosis Sympathetic; Sympathetic Ocular-Ophthalmoplegia; Acquired Horner Syndrome; Bernard Syndromes; Bernards Syndrome; Central Horner Syndrome; Claude Bernard Horner Syndrome; Horner Syndrome, Pupil; Horners Syndrome; Horners Syndrome, Pupil; Ocular Ophthalmoplegia, Sympathetic; Ocular Ophthalmoplegias, Sympathetic; Ocular-Ophthalmoplegia, Sympathetic; Ocular-Ophthalmoplegias, Sympathetic; Oculosympathetic Syndromes; Ophthalmoplegias, Sympathetic Ocular; Pupil Horner's Syndrome; Sympathetic Ocular Ophthalmoplegia; Sympathetic Ocular Ophthalmoplegias; Sympathetic Ocular-Ophthalmoplegias; Syndrome, Acquired Horner; Syndrome, Bernard; Syndrome, Bernard's; Syndrome, Central Horner; Syndrome, Claude Bernard-Horner; Syndrome, Oculosympathetic; Syndrome, Pupil Horner's; Syndromes, Bernard; Syndromes, Oculosympathetic; Miosis, Innervational Defect; Oculosympathetic Syndrome

Networked: 366 relevant articles (11 outcomes, 8 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Paresis (Hemiparesis)
2.	Miosis
3.	Infection
4.	Blepharoptosis (Ptosis, Eyelid)
5.	Acquired Immunodeficiency Syndrome (AIDS)

Experts

1.	Brown, Sandra M: 3 articles (06/2005 - 08/2003)
2.	Bischof, Georg: 2 articles (08/2013 - 12/2003)
3.	Bosmans, Tim: 2 articles (03/2011 - 07/2009)
4.	Pishdad, Reza: 2 articles (03/2011 - 09/2008)
5.	Gasthuys, Frank: 2 articles (03/2011 - 07/2009)
6.	Pishdad, Parisa: 2 articles (03/2011 - 09/2008)
7.	Marcilla, Miguel Gozalo: 2 articles (03/2011 - 07/2009)
8.	Schauvliege, Stijn: 2 articles (03/2011 - 07/2009)
9.	Polis, Ingeborgh: 2 articles (03/2011 - 07/2009)
10.	Pishdad, Gholam Reza: 2 articles (03/2011 - 09/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Horner Syndrome:

1.	apraclonidine (Iopidine)FDA LinkGeneric 09/01/2006 - "Efficacy of apraclonidine 0.5% in the diagnosis of Horner syndrome in pediatric patients under low or high illumination." 09/01/2006 - "The application of apraclonidine in pediatric patients is safe and effective in the diagnosis of Horner syndrome. " 06/01/2006 - "The application of 0.5% apraclonidine in pediatric patients is safe and effective in the diagnosis of Horner syndrome." 03/01/2010 - "A review of all reported cases of apraclonidine testing in Horner syndrome suggests that this is a promising diagnostic adjunct that must be validated in larger studies." 01/01/2009 - "This study aimed at developing through three clinical cases, the usefulness of topical apraclonidine 0.5% to confirm a diagnosis of Bernard-Horner syndrome. "
2.	Cocaine (Cocaine HCl)IBA 03/01/1990 - "We found the cocaine test to be highly effective in separating normal subjects from patients with Horner's syndrome. " 06/01/2001 - "Patients should be informed that their urine may test positive for cocaine, if assayed according to US federal guidelines and using the protocol employed in this study, up to 2 days after undergoing testing for Horner syndrome." 06/01/2006 - "This was a randomized, crossover study, wherein 10 patients with a probable diagnosis of Horner syndrome were assigned to undergo pharmacological testing with 4% cocaine and 0.5% apaconidine. " 06/01/2001 - "Duration of positive urine for cocaine metabolite after ophthalmic administration: implications for testing patients with suspected Horner syndrome using ophthalmic cocaine." 11/01/2000 - "The Horner's syndrome was confirmed with a 4% cocaine test. "
3.	Phenylephrine (Neo-Synephrine)FDA LinkGeneric 05/01/1999 - "The response to neosynephrine is positive in Claude Bernard Horner syndrome and aponeurotic disinsertion. " 01/15/1994 - "An unilateral ptosis in an African spotted eagle own was ameliorated by topical treatment with phenylephrine, strongly suggesting a diagnosis of Horner's syndrome, the first recorded case of this syndrome in a bird." 01/01/2009 - "Denervation supersensitivity to 1% phenylephrine in Horner syndrome can be demonstrated 10 days after the onset of symptoms." 02/01/1990 - "The predictability of the phenylephrine test and the efficacy of the Muller's muscle-conjunctival resection procedure in the management of blepharoptosis in six cases of Horner's syndrome were assessed. " 01/01/2003 - "Shortening of the elongated and thinned Müller's muscle by instillation of phenylephrine, and surgical shortening, and fixation of the disinserted, elongated, and thinned aponeurosis using the orbital septum, restored involuntary tonic contraction of the levator muscle in nearly all of 2000 patients with aponeurotic blepharoptosis and in 11 patients with Horner syndrome."
4.	Ophthalmic Solutions (Eye Drops)IBA 07/15/1990 - "Because normal variability in the response to the eyedrops may influence the interpretation of test results in patients with Horner's syndrome, we studied both the interocular variability of the drug's mydriatic effect within each normal subject and the variation between individuals. " 06/01/2011 - "Confirmation of Horner's syndrome using apraclonidine eye drops." 02/01/2008 - "Testing for Horner syndrome still needs to be done with cocaine eye drops. " 02/01/2008 - "Apraclonidine eye drops have been suggested to diagnose Horner syndrome. " 06/01/2007 - "We identified three patients, who had previously undergone various investigations, including a muscle biopsy, whose lid ptosis disappeared using eye drops containing naphazoline nitrate, a sympathomimetic drug, thus suggesting partial Horner's syndrome. "
5.	Ganciclovir (Cytovene)FDA LinkGeneric 01/21/1998 - "Since Horner's syndrome and mononeuritis multiplex in the present case were both improved by ganciclovir, it is important to consider CMV infection when Horner's syndrome or mononeuritis multiplex is observed in immunocompromised patients, such as those with HIV-1 infection or AIDS, even if they do not show any other opportunistic infections."
6.	Edrophonium (Tensilon)FDA LinkGeneric 07/01/1978 - "In a 12-year-old girl with Horner's syndrome and an ipsilateral accommodative paresis, intravenous administration of edrophonium chloride improved the accommodative defect on several occasions, which suggested a possible relationship to myasthenia gravis. "
7.	p-Hydroxyamphetamine (Hydroxyamfetamine)FDA Link 03/01/2003 - "However, the hydroxyamphetamine test may be positive even after the ophthalmic signs of Horner syndrome have disappeared." 08/01/2001 - "Hydroxyamphetamine drops for Horner's syndrome." 01/01/2000 - "A right, third-order neuron Horner's syndrome was confirmed with 1% hydroxyamphetamine topical drops. " 12/01/1996 - "Two patients with acute unilateral Horner's syndrome whose pupils initially dilated equally to hydroxyamphetamine had pharmacologic localization to the postganglionic nerve in the second week following the onset of symptoms. " 12/01/1996 - "False-negative hydroxyamphetamine (Paredrine) test in acute Horner's syndrome."
8.	Adrenergic Agents (Adrenergic Drugs)IBA 04/01/1992 - "It is possible to assess the pupillary sensitivity to topical adrenergics of the patients with bilateral Horner's syndrome by comparing the age-related normal values obtained in this study."
9.	Retinaldehyde (Retinal)IBA 01/01/2000 - "A useful rule is that the coincidence of any local pain in neck or face with an ipsilateral Horner's syndrome preceding transient or persistent retinal or cerebral ischemic symptoms should alert physicians--notably those treating emergencies--to rule out an underlying dissection of the ipsilateral carotid artery. " 07/01/1987 - "Post-operative neuro-ophthalmological complications developed in 80/312 (25.6%) patients and included: areas of retinal infarction (17.3%); retinal emboli (2.6%); visual field defects (2.6%); reduction of visual acuity (4.5%) and Horner's syndrome (1.3%). " 06/01/2005 - "A typical picture of local pain, headache, and ipsilateral Horner's syndrome followed after several hours by cerebral or retinal ischaemia is rare. " 02/01/2010 - "Twelve patients were symptomatic: six presented neurological events (four strokes, two transient ischemic attack [TIA]); two retinal events; three compressive symptoms (two Horner's syndrome and one paralysis of the glossopharyngeal nerve); one patient presented a visible pulsatile mass in the neck. " 10/01/1992 - "Pain is the leading symptom and is associated with other focal signs such as Horner's syndrome and painful tinnitus or with signs of cerebral or retinal ischemia. "
10.	Bupivacaine (Bupivacaine Hydrochloride)FDA LinkGeneric 01/01/2012 - " this case report, we presented a case of Horner's syndrome after performing an ultrasound-guided infraclavicular brachial plexus block with 15 mL of bupivacaine 0.5%. " 06/01/2002 - "We present, for the first time, two parturients who developed Horner's syndrome with diluted Bupivacaine. " 08/01/1999 - "The most probable explanation for this peripheral Horner's syndrome is a subdural blockade caused by the first bupivacaine doses. " 01/01/1998 - "While Horner's syndrome is a rare and occasionally reported complication of epidural 'top-ups' administered for labour and Caesarean delivery, the case reported here followed a low-dose epidural infusion of bupivacaine. " 07/01/1988 - "Although all four blocks were successful, which was evidenced by a Horner syndrome as well as elevated skin temperature 1-2 min after the injection of 7 ml bupivacaine (C6/C7), in all four cases residual sympathetic activity could be measured. "

Therapies and Procedures

1.	Sympathectomy (Sympathectomies) 01/01/1987 - "Good results, without Horner's syndrome, were obtained with extensive postganglionic sympathectomy. " 02/01/2014 - "[Irreversible Horner's syndrome after bilateral thoracoscopic sympathectomy]." 08/01/2013 - "Impact of T3 thoracoscopic sympathectomy on pupillary function: a cause of partial Horner's syndrome?" 04/01/2012 - "Impact of T3 thoracoscopic sympathectomy on pupillary function: a cause of partial Horner's syndrome?" 09/01/2010 - "Sympathectomy led to a higher incidence of ipsilateral Horner's syndrome compared with sympathotomy."
2.	Lasers (Laser) 04/01/2006 - "Laser-Doppler flowmetry and Horner's syndrome in patients with complete unilateral damage to the parasellar sympathetic fibers during cavernous sinus surgery." 03/01/2008 - "The laser allows the use of a single port, requires less dissection than surgical or clipping techniques, is more precise than diathermy and may be less likely to cause a Horner's syndrome." 11/01/1992 - "The efficacy of these combinations was assessed by registering the following changes in effector organ activity: (1) observed signs (e.g., Horner's syndrome: miosis, ptosis, enophthalmos, and reddening of the sclera) and (2) objective measurements of changes in skin temperature, skin blood flow (laser Doppler flowmetry), skin resistance response, and in skin resistance level. "
3.	Epidural Anesthesia 03/01/2015 - "Thoracic epidural anesthesia was successful in 439 patients, with six (1.4%) of these patients acquiring Horner's syndrome. " 03/01/2015 - "Transient Horner's syndrome is an uncommon complication of epidural anesthesia, though its exact incidence in thoracic epidural anesthesia is not clear. " 09/01/2011 - "It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner's syndrome in a postpartum female. " 02/01/2011 - "After completion of this activity, physicians will be able to educate healthcare professionals working on the labor ward to be able to estimate the small incidence of Horner Syndrome following epidural anesthesia administered in labor. " 02/01/2011 - "We report a case of transient Horner syndrome following epidural anesthesia and a review of the literature. "
4.	Mastectomy (Mammectomy) 03/01/2015 - "Therefore, this study prospectively evaluated the incidence of Horner's syndrome after thoracic epidural anesthesia for mastectomy. " 03/01/2015 - "Transient Horner's syndrome following thoracic epidural anesthesia for mastectomy: a prospective observational study." 03/01/2015 - "The incidence of Horner's syndrome following thoracic epidural anesthesia and continuous thoracic epidural analgesia for mastectomy was 1.4%. " 12/01/2005 - "A patient undergoing left mastectomy and immediate latissimus dorsi breast reconstruction under combined paravertebral block and general anaesthesia developed transient, well-demarcated, right-sided hemifacial erythema and sweating, and left-sided Horner syndrome postoperatively. "
5.	Nerve Block (Nerve Blocks) 05/01/2012 - "The aim of this study was to determine if the use of ultrasound guidance (vs. peripheral nerve stimulator, (PNS)) decreases risk of vascular puncture, risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block. "