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Cranial nerves
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
FALSE – Horner’s syndrome is caused by a lesion to the sympathetic pathway and hence the patient may present with a fixed unilateral constricted pupil (unopposed innervation from the Edinger-Westphal nucleus), ptosis, enophthalmos and loss of sweating on the same side of the face or body. ‘MAPLE’: Miosis, Anhydrosis, Ptosis, Loss of ciliospinal reflex and EnophthalmosCauses include cerebral infarction, syringomyelia, apical tumours of the bronchus, trauma to the brachial plexus, and after dissection of the neck (e.g. thyroidectomy).2
Brachial Plexus Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Janice He, Bassem Elhassan, Rohit Garg
Inspection can also demonstrate special signs of neurologic injury that suggest pre-ganglionic injury (Table 12.3). Specifically, the loss of bulk of the paraspinal musculature of the neck and rhomboids implies injury to the dorsal rami and dorsal scapular nerve (C5), which are associated with pre-ganglionic plexus injury. Horner syndrome, consisting of ptosis of the ipsilateral eyelid and miosis of the ipsilateral eye corresponds to cervical sympathetic injury, which is also associated with pre-ganglionic injury.
Neurology
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Common cause of stroke in young patients and can occur spontaneously or after trauma. Patients often have ipsilateral neck pain followed by a focal neurological deficit (stroke). » 50% of patients present with a Horner’s syndrome.
Carotid artery dissection due to an elongated styloid process: A case report and implications for the otolaryngologist
Published in Acta Oto-Laryngologica Case Reports, 2022
Keisuke Kondo, Tomosuke Kitagawa, Yuko Hata, Kozo Fukuyama, Keiji Honda
It is important to identify the etiology of ptosis accurately and differentiate Horner syndrome from facial nerve paralysis. The diagnosis of Horner syndrome is straightforward when a patient presents all of the typical symptoms of anhidrosis, miosis, ptosis, loss of ciliospinal reflex, and enophthalmos. However, as in this case, several cases show only a partial symptomatology [4]. Moreover, recognizing ptosis can be difficult when the frontalis muscles are poorly developed owing to age or congenital factors. In such cases, it is useful to ask an ophthalmologist for the apraclonidine eye drop test [5] and a neurologist for the complete neurological examination and the physical examination. Once Horner syndrome is confirmed, imaging tests such as radiography, MRI, CT, or carotid artery ultrasound should be performed to identify the underlying cause.
Eyelid Myokymia with Concomitant Cerebral Tumour: A Case Report
Published in Neuro-Ophthalmology, 2018
Yoshiyuki Kitaguchi, Maria Suzanne Sabundayo, Hirohiko Kakizaki
Upper eyelid ptosis with reverse ptosis is a common presentation of eyelid myokymia. This appearance results from the continuous involuntary contractions of the orbicularis oculi muscle.6 Facial nerve palsy, Horner syndrome, and enophthalmos also illustrate similar symptoms with different pathologies.7 The facial nerve palsy decreases the tone of the orbicularis oculi muscle, resulting in disuse atrophy of the upper and lower eyelid retractors.8 Horner syndrome, in relation to an interrupted oculosympathetic pathway, attenuates the smooth muscle component of the eyelids. The enophthalmos lowers the position of the Whitnall’s ligament with decreased support by the globe, which causes functional lengthening of the levator palpebrae superioris9; pseudo-reverse ptosis may be seen when the globe is depressed.
40th Meeting of the Upper Midwest Neuro-Ophthalmology Group
Published in Neuro-Ophthalmology, 2019
Amr Sabbagh, a medical student from the University of Michigan, reported a study of 107 inpatients and outpatients with apraclonidine-positive Horner syndrome discovered through a text search of the electronic medical records from that institution between 2001 and 2018. In nearly half of cases, no cause was discovered. Among cases in which a cause was determined, the most common cause was a prior surgical procedure or central venous line placement. Other prominent causes were cervical carotid dissection and cluster headache. Unlike earlier studies, tumour and stroke were minor causes. Comparison of these results to those of earlier studies led to the conclusion that the prevalence of causes of Horner syndrome will vary according to the case accrual method.