Horner Syndrome: 5 case reports

Abstract

Background: Horner syndrome (HS) or oculosympathetic paresis is caused by the interruption of the sympathetic nervous pathway at any point from the brain to the eye. Clinical signs include miosis, upper lid ptosis, anhydrosis of the face, enophtalmus and iris heterochromia. Although it is usually a benign condition, the proximity of the sympathetic pathway to carotid arteries, thoracic structures and central nervous system requires a careful ruling out of life-threatening conditions.

Objective: To describe the utility of clinical history and neurological examination in the assessment of the etiology and localization of lesions causing Horner syndrome.

Methods: Review of cases presented at the Neurology Unit of Catholic University of Chile during 2003-2004.

Results: 5 patients were identified with an age distribution of 2-72 months. 4 cases were congenital and 1 acquired. Neurological signs allowed to classify the cases of HS in peripheral (4) and central (1). Hemianhydrosis suggested that 3 cases were preganglionic and 2 postganglionic.

Conclusions: History and neurological examination in cases of HS is usually enough to define the localization of the lesion. Further laboratory evaluation is unnecessary.