Horner's syndrome

Horner's syndrome is a rare syndrome that links symptoms and signs caused by lesions of neural network pathways from the brain to the face. This nerve injury will affect the appearance of abnormalities in one part of the eye.

This syndrome occurs in patients with diseases such as stroke, spinal cord injury or tumor. Therefore, the treatment of Horner's syndrome is done by treating a disease that is felt by the patient. Treatment of basic conditions is very useful for restoring nerve tissue function and allowing it to return to normal.

Symptoms of Horner's syndrome are characterized by smaller pupils. Other symptoms that can be felt by people with Horner's syndrome are the amount of sweat that comes out less and the eyelids look loose on one side of the face.

Horner's syndrome

Symptoms of Horner's syndrome

The symptoms of Horner's syndrome only affect one side of the patient's face. Some of the symptoms and clinical signs of Horner's syndrome are:
  • The size of the two pupils looks very different, one of which is very small at the size of a dot.
  • One lower eyelid is slightly higher (reverse ptosis).
  • Some faces sweat a little or not at all.
  • Delayed enlarged pupils (dilation) in low light conditions.
  • Eyes like glass and red (red eyes).

The symptoms of Horner's syndrome in adults and children are generally similar. It's just that in adults with Horner's syndrome, you usually experience pain or headaches. While in children, there are some additional symptoms, namely:

The color of the iris is paler in the eyes of children under one year.
Parts of the face affected by Horner's syndrome do not appear reddish (hot flashes) when exposed to sunlight, exercise, or emotional reactions.

Causes of Horner's syndrome


Horner's syndrome is caused by lesions of several pathways of the sympathetic nervous system, which lie between the brain and face. This nervous system plays a role in regulating heart rate, pupil size, sweating, blood pressure and other functions, which allow the body to respond quickly to changes in the environment.

Nerve cells (neurons) that are affected by Horner's syndrome are divided into 3 types, namely:
  • First-order neurons. Located in the hypothalamus, brain stem and upper spine. Medical conditions that cause Horner's syndrome that occur in nerve cells of this type are usually strokes, tumors, diseases that cause the loss of myelin (a protective layer of nerve cells), neck injuries and the presence of cysts or holes in the spine.
  • Second-level neurons. There are several in the spine, at the top of the chest and on the sides of the neck. Lung cancer, myelin lining tumors, damage to the main blood vessels of the heart (aorta), surgical interventions in the chest cavity and traumatic lesions are pathological conditions that can damage the nerves of this area.
  • Third-level neurons. Located on the side of the neck that leads to facial skin and the muscles of the eyelids and iris. Damage to this nerve cell type can be related to neck arteries, neck blood vessels, tumors or infections of the skull base, migraines and cluster headaches.

In children, common causes of Horner's syndrome are neck and shoulder injuries at birth, aortic abnormalities at birth, or tumors of the nervous system and hormones. A number of cases of Horner's syndrome cannot be identified as idiopathic Horner's syndrome.


Diagnosis and treatment of Horner's syndrome
The diagnosis of Horner's syndrome is quite complicated because the symptoms may indicate other diseases. In addition, the doctor will also ask questions about patients with a history of certain illnesses, injuries, or surgeries.

Doctors can suspect a patient with Horner's syndrome if he has symptoms that are strengthened by physical examination. During a physical examination, the doctor detects symptoms such as pupils on one of the eyeballs, eyelids that are lower than the eyelids, or sweat that does not appear on one side of the face.

To ensure that the patient has Horner's syndrome, the doctor will perform other tests, such as:
  • Eye examination. The doctor will examine the patient's pupillary response. The doctor will give a small dose of eye drops to dilate the patient's pupils. A dilated pupillary reaction can indicate that the patient has Horner's syndrome.
  • Imaging test. A number of tests, such as ultrasonography, x-rays, computed tomography or MRI, will be performed on patients with structural abnormalities, lesions or tumor lesions.

There is no specific treatment to treat Horner's syndrome. In many cases, if the cause has been treated, the disease goes away by itself.
Complications of Horner's syndrome

The following are a number of complications that Horner's syndrome may have:
  • Vision loss
  • Neck pain or severe headaches and sudden attacks
  • Weak muscles or difficulty controlling muscles









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