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Syndrome
Group 1D
David Ho, Emma Josey, Steven Lin, Nhi Nguyen, Melitta Tanzer, Jessie Whiley
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
An Overview
Trimester 2,
2015
Horners Syndrome
Group 1D
Horners Syndrome
The
History
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
Figure 2
http://fidoseofreality.com/wpcontent/uploads/2014/09/cocker_leo.jpg
4
Trimester 2,
2015
Horners Syndrome
Group 1D
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Trimester 2,
2015
Horners Syndrome
Group 1D
Figure 3
(Amonoo-Kuofi, HS 1999)
Horners Syndrome
The
Anatomy
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
Trimester 2,
2015
Horners Syndrome
Group 1D
Trimester 2,
2015
Horners Syndrome
Group 1D
Figure 5
Trimester 2,
2015
Horners Syndrome
Group 1D
Horners Syndrome
The
Etiology
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
The Etiology
Central
Preganglionic
Figure 6
Congenital
11
Postganglionic
Trimester 2,
2015
Horners Syndrome
Group 1D
http://www.adlergiersch.com/post-traumaticsyringomyelia/
Horners Syndrome
The
Pathophysi
ology
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
The Pathophysiology
13
Trimester 2,
2015
Horners Syndrome
Group 1D
(Gralapp, C 2015)
14
Dilation Lag
Anhidrosis
(lack of sweating, leading to dry skin)
Trimester 2,
2015
Horners Syndrome
Figure 8
http://patient.info/doctor/horners-syndrome
Group 1D
Pathway: Originates from side of neck and into face, innervating facial skin and muscles
of iris and eyelids
Third
Affected Area: Area above ipsilateral brow or forehead
Order
Symptoms: Minimal anihidrosis, orbital pain/headaches
Neurons
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Trimester 2,
2015
Horners Syndrome
Group 1D
Figure 9
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Trimester 2,
2015
Horners Syndrome
https://classconnection.s3.amazonaws.com/448/flashcards/56448/png/capture1316217505465.png
Group 1D
Symptoms:
Figure 10
17
Trimester 2,
2015
Horners Syndrome
Group 1D
Horners Syndrome
The
Epidemiolo
gies
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
The Epidemiologies
19
Trimester 2,
2015
Horners Syndrome
Figure 11
Group 1D
http://www.umweltbundesamt.de/en/topics/health/assessing-environmentallyrelated-health-risks/epidemiology
Horners Syndrome
Diagnose
s&
Treatmen
t
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
87% accuracy
Normal Pupil
Horners
Pupil
21
Trimester 2,
2015
Horners Syndrome
Denervated
Dominant
alpha 2
receptor
activity
Miosis or no
effect on
size
Increased
alpha 1
receptor
numbers
Group 1D
Mydriasis
22
Trimester 2,
2015
Horners Syndrome
Denervate
d
https://lh4.googleusercontent.com/489j2ewJXWc_A2got6CJ0ix8o4G_T8tyjWm0PPr_NZhZok8miOURWZrt1pMRz1smEDMikdBi_rCiM3aSzZL2W61796Bw_5Ig2gWhOS5uwRMn0ypGeEj1BIl
No effect
on size
Group 1D
Helps to distinguish between first or second order neuron lesion from Third order
(postganglionic) neuron lesion and is pictured in Figure 13
Applied 24-48 hours after the cocaine eye drop test to prevent
Interference with drug uptake
23
Trimester 2,
2015
Horners
Pupil with
intact
postgangli
onic
neuron
Noradrenal
ine present
Mydriasis
Horners
Pupil with
damaged
postgangli
onic
neuron
Noradrenal
ine absent
No effect
on size
Horners Syndrome
Figure 13
http://images.medscape.com/pi/features/drugdirectory/octupdate/AKN07040.jpg
Group 1D
MRI or CT scans
MRI, as pictured in Figure 14, is mainly used for soft tissue examination, takes
approximately 30 minutes to conduct and can be relatively expensive
CT is mainly used on bones, lung and chest injuries or cancers, takes
approximately 5 minutes to conduct, uses radiation but can be cheaper
Painful Horner syndrome may indicate carotid artery dissection MRI of brain and
neck
Stroke CT of head
Figure 14
(George, Haydar
& Adams 2008)
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Trimester 2,
2015
Horners Syndrome
Group 1D
25
Trimester 2,
2015
Horners Syndrome
Group 1D
Horners Syndrome
Case
Studies
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
Summary of Etiology
Figure 15
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Trimester 2,
2015
Horners Syndrome
Group 1D
Case Study #1
Figure 16 shows the mans right eye with miosis and partial ptosis (A) and
haematoma at the site of the carotid artery dissection
Figure 16
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Trimester 2,
2015
Horners Syndrome
Group 1D
Case Study #2
25 year old man was attacked and stabbed (Dubois-Marshall, S & De Kock, S
2011)
Doctors treated and stitched, however a few days later the patient noticed
signs of Horners Syndrome, as shown in Figure 17
An X-ray was taken at the location of the original stab wound, shown in Figure
18, and it showed that the blade of the knife was still inside his neck, lodged in
a position that was disrupting nerve innervation
Trimester 2,
2015
Horners Syndrome
Case Study #3
30
Further investigations and neurological scans were taken due to the blunt
trauma to the boys neck suspected to have caused a carotid artery
dissection (much like Case Study #1)
Trimester 2,
2015
Horners Syndrome
Group 1D
Case Study #4
3 year old red bellied parrot who was pinned to the ground by a white
cockatoo who proceeded to apply pressure to the parrots upper back and
lower neck
(Ganca, A et al. 2005)
Following the incident, the parrot showed ptosis of the left eye, whilst the
right eye was normal, this change in symptoms is respectively shown in
Figure 19
Figure 19
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Trimester 2,
2015
Horners Syndrome
Group 1D
32
Horners Syndrome A
summary
Distinguished as an official condition in 1869 after previous nerve experimentation and research of nerves in dogs
Is a rare condition caused by disruption of oculosympathetic nerve pathway (at either central, ganglionic or
postganglionic locations) with main symptoms of miosis, ptosis and anhidrosis
Equal prevalence amongst age groups, with males more likely to contract and congenital cases being more common
Diagnosed mainly by Apraclonidine eye drop testing, MRI or CT scans, with localisation determined by
Hydroxyamphetamine eye drops
No effective treatment for condition, but there is usually a treatment for the underlying cause and once treated
symptoms can be reduced
Despite small prevalence of disease, large number of case studies are reported to effectively inform health
professionals and general public of underlying health complications that can be contributing to Horners Syndrome
Trimester 2,
2015
Horners Syndrome
Group 1D
Thank
you
Horners
Syndrome
Group 1D
David Ho, Emma Josey, Steven Lin, Nhi Nguyen, Melitta Tanzer, Jessie Whiley
(George, Haydar & Adams 2008)
http://frontierdreams.blogspot.com.au/2011/04/hornerssyndrome.html
References
4designersart 2013, Epidemiology, Umwelt Bundesamt, 21/09/2015, <http://www.umweltbundesamt.de/en/topics/health/assessing-environmentally-related-health-risks/epidemiology>.
Amonoo-Kuofi, HS 1999, 'Horner's syndrome revisited: with an update of the central pathway', Clinical Anatomy (New York, N.Y.), vol. 12, no. 5, pp. 345-61George, A, Haydar, A & Adams, W 2008a, 'Imaging
of Horner's Syndrome', Clinical Radiology, vol. Volume 63, no. Issue 5, pp. pp. 499-505.
Bazari, F, Hind, M & Ong, Y 2010, 'Horner's Syndrome - not to be sneezed at ', The Lancet, vol. 375.
Bryant, C 2014, Health Condition Threatens Dog Vision, 21/09/2015, <http://fidoseofreality.com/health-condition-threatens-dog-vision/>.
Dubois-Marshall, S & De Kock, S 2011, 'Two days with a broken knife blade in the neck - an interesting case of Horner's Syndrome', Emergency Medical Journal, vol. 28, pp. 629-31.
Ganca, A, Malka, S, Sandmeyer, L, Cannon, M, Smith, D, Taylor, M 2005, Horners syndrome in a red-bellied parrot (Poicephalus rufiventris), Journal of Avian Medicine and Surgery, vol. 19, no. 1, pp. 30-34,
retrieved 21 September 2015, <http://www.bioone.org/doi/full/10.1647/2004-017>
George, A, Haydar, A & Adams, W 2008, Imaging of Horner's Syndrome, Clinical Radiology, <https://www.clinicalkey.com.au/#!/content/journal/1-s2.0-S0009926008000123>.
Gralapp, C 2015, Sympathetic Pathway, ONE Network, 21/09/2015, <http://www.aao.org/image/sympathetic-pathway-3>.
H., D 2011, Exam 2, Studyblue, 18/09/2015, <https://www.studyblue.com/notes/note/n/exam-2/deck/1122222>.
Kelly A. Walton, LMB 2003, 'Horner syndrome', Current Opinion in Ophthalmology, vol. 14, no. 1, pp. 357-63.
Kexin, M, Wei, T, Zhenye, LV & Xiangyang, S 2015, 'Horner's syndrome subsequent to minimally invasive video-assisted thyroidectomy in two patients', Oncology Letters, vol. 10, no. 1, pp. 459-62.
Kneller, SK, Lewis, RE & Oliver, JE 1972, Horner's syndrome following common carotid artery catheterization in cats, 10, Blackwell Publishing Ltd, 1748-5827, <
http://dx.doi.org/10.1111/j.1748-5827.1972.tb06803.x>.
Kong, YX, Wright, G, Pesudovs, K, ODay, J, Wainer, Z & Weisinger, HS 2007, 'Horner syndrome', Clinical and Experimental Optometry, vol. 90, no. 5, pp. 336-44.
Mirzai, H & Baser, EF 2006, 'Congenital Horner's syndrome and the usefulness of the apraclonidine test in its diagnosis', Indian J Ophthalmol, vol. 54, no. 3, pp. 197-9.
Newman JN, Kedar S & Biousse V 2015, Horner Syndrome, UpToDate, retrieved 20 September 2015, http://www.uptodate.com/contents/horner-syndrome
Payne, J 2015, Horner's Syndrome, Patient, 20/09/2015, <http://patient.info/doctor/horners-syndrome>.
Reede, D, Garcon, E, Smoker, W & Kardon, R 2008, Horner's Syndrome: Clinical and Radiographic Evaluation, Neuroimaging Clinic of North America <
https://www.clinicalkey.com.au/#!/content/journal/1-s2.0-S1052514907001219?scrollTo=%231-s2.0-S1052514907001219-gr1>.
The Reed Group 2014, Post Traumatic Syringomyelia, diagram, retrieved 21 September 2015, http://www.adlergiersch.com/post-traumatic-syringomyelia/
Spring, N 2011, Horners Syndrome, infant diagnosed with Horners Syndrome, Frontier Dreams, retrieved 23/09/2015, http://frontierdreams.blogspot.com.au/2011/04/horners-syndrome.html
Starr, BE, Shubert, RA & Baumann, B 2004, 'A child with isolated Horner's syndrome after blunt neck trauma', The Journal of Emergency Medicine, vol. 26, no. 4, pp. 425-7.
tcooper 2013, Neuro-ophthalmology, Stanford Medicine Ophthalmology, 20/09/2015, <
http://ophthalmology.stanford.edu/blog/archives/2013/09/neuro-ophthalmology-question-of-the-week-anisocoria-6-horner-syndrome-cocaine-test-continued.html>.
WebMD 2015, Paremyd Ophthalmic, 21/09/2015, <http://www.webmd.com/drugs/2/drug-64194/paremyd-ophthalmic/details#images>.
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Horners Syndrome
Group 1D