Positive apraclonidine test 36 hours after acute onset of horner syndrome in dorsolateral pontomedullary stroke.

Abstract

A 40-year-old man developed a Horner syndrome as part of a dorsolateral medullary brainstem infarction. Thirty-six hours after the onset of the stroke, topical instillation of 0.5% apraclonidine produced reversal of anisocoria. This is the first case in which apraclonidine testing has been applied to a patient with a Horner syndrome caused by a lesion in the first segment of the oculosympathetic pathway and the shortest reported interval between clinical manifestations of the lesion and apraclonidine-induced reversal of anisocoria. 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.

• Authors: Maud Lebas, Julien Seror, Thomas Debroucker
• Journal: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society (J Neuroophthalmol) Vol. 30 Issue 1 Pg. 12-7 (Mar 2010) ISSN: 1536-5166 [Electronic] United States
• PMID: 20182200 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Adrenergic alpha-Agonists
• apraclonidine
• Clonidine

Topics

• Adrenergic alpha-Agonists
• Adult
• Clonidine (analogs & derivatives)
• Horner Syndrome (diagnosis, etiology)
• Humans
• Magnetic Resonance Angiography (methods)
• Magnetic Resonance Imaging
• Male
• Pons (pathology)
• Stroke (complications, pathology)