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Horner syndrome

Oculosympathetic paresis

 

Horner syndrome is a rare condition that affects the nerves to the eye and face.

Causes

 

Horner syndrome can be caused by any interruption in a set of nerve fibers that start in the part of the brain called the hypothalamus and travel to the face and eyes. These nerve fibers are involved with sweating, the pupils in your eyes, and some of the muscles around your eyes.

Damage of the nerve fibers can result from:

  • Injury to the carotid artery, one of the main arteries to the brain
  • Injury to nerves at the base of the neck called the brachial plexus
  • Migraine or cluster headaches
  • Stroke, tumor, or other damage to a part of the brain called the brainstem
  • Tumor in the top of the lung
  • Injections or surgery done to interrupt the nerve fibers and relieve pain (sympathectomy)

In rare cases, Horner syndrome is present at birth. The condition may occur with a lack of color (pigmentation) of the iris (colored part of the eye).

 

Symptoms

 

Symptoms of Horner syndrome may include:

  • Decreased sweating on the affected side of the face
  • Drooping eyelid (ptosis)
  • Sinking of the eyeball into the face
  • Small (constricted) pupil (the black part in the center of the eye)

There may also be other symptoms, depending on the disorder that is causing the nerve damage.

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about the symptoms.

An eye exam may show:

  • Changes in how the pupil opens or closes
  • Eyelid drooping
  • Red eye

Depending on the suspected cause, tests may be done, such as:

  • Blood tests
  • Blood vessel tests of the head (angiogram)
  • Chest x-ray or chest CT scan
  • MRI or CT scan of the brain
  • Spinal tap (lumbar puncture)

You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).

 

Treatment

 

Treatment depends on the cause of the problem. There is no treatment for Horner syndrome itself. The provider can tell you more.

 

Outlook (Prognosis)

 

The outcome depends on whether treatment of the cause is successful.

 

Possible Complications

 

There are no direct complications of Horner syndrome itself. But, there may be complications from the disease that caused Horner syndrome or from its treatment.

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of Horner syndrome.

 

 

References

Baloh RW, Jen JC. Neuro-ophthalmology. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 424.

Thurtell MJ, Rucker JC. Pupillary and eyelid abnormalities. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 18.

 
  • Central nervous system

    Central nervous system - illustration

    The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

    Central nervous system

    illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Horner syndrome

           

             

            Review Date: 5/30/2016

            Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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