HomeHealth articleshorner's syndromeWhat Is Horner Syndrome?

Horner Syndrome - Types, Symptoms, Diagnosis, and Treatment

Verified dataVerified data
0

4 min read

Share

Horner syndrome is characterized by changes in one side of the face due to an obstruction of nerves from the brain to the head and neck. Read further.

Written by

Dr. Sumithra. S

Medically reviewed by

Dr. Abhishek Juneja

Published At October 17, 2022
Reviewed AtFebruary 6, 2023

Introduction:

Horner syndrome is a rare condition that affects one side of the face, including the eyes. This is caused due to the obstruction in the path of nerves starting from the brain, and reaching the face and neck. The primary function of this nerve is the dilation and constriction of pupils. Therefore, obstruction of this nerve can result in many changes in the eyes and face. Though this condition does not cause any major life-altering symptoms, it can be a sign of a severe underlying medical condition. Horner syndrome is also known by other names such as oculosympathetic palsy or Bernard-Horner syndrome. It can occur in all age groups, both in males and females and in people of all ethnicities.

This article will discuss the causes, symptoms, diagnosis, and management of horner syndrome in detail.

What Are the Causes of Horner Syndrome?

Horner syndrome can be both congenital and acquired.

  • Congenital: Congenital horner syndrome is caused due to an injury to the nerve during birth. It can be passed on from parents through no specific genes. It can also be caused due to neuroblastoma, and a defective aorta.

  • Acquired: Acquired Horner syndrome is caused due to various underlying medical conditions: head and neck trauma, lung and thyroid tumor, cranial nerve (a rare condition), embolism, stroke, and infections. It can also occur as a complication from surgery.

  • Idiopathic: in the case of idiopathic Horner syndrome, the causes are not known.

What Are the Three Types of Horner Syndrome?

Horner syndrome affects the pathway of sympathetic nerves. The sympathetic nervous system is responsible for the body's prompt response to the events occurring in the environment (mainly stressful conditions). The sympathetic nerves are in charge of the heart rate, blood pressure levels, pupil size, and perspiration (the process of sweating). There are three different neurons believed to be involved. Horner syndrome tends to affect any of the neurons, and the damages are different.

1. First-Order Neurons:

The first-order neurons will start from the base of the brain - the hypothalamus, lead the way through the brainstem and connect with the upper portion of the spinal cord. The function of nerves in this region is affected due to medical conditions like,

  • Stroke - It is characterized by damage to the arteries present in the brain. High blood pressure is the main causative factor of it.

  • Injury - Injury to the neck.

  • Infections - Infections or diseases affecting the protective myelin lining of the neurons.

  • Syringomyelia - It is characterized by a fluid-filled cyst in the spinal cord. It can grow bigger and damage the spinal cord, causing pain.

2. Second-Order Neurons:

The second-order neurons will have their course across the spinal column and extend to the upper part of the chest and the side of the neck.

Some of the medical conditions affecting the nerves present in this region are,

  • Surgeries are done to the chest.

  • Aorta - heart’s primary blood vessel gets damaged.

  • Lung cancer.

  • Trauma or an injury.

  • Schwannoma tumors - are rare tumors of the nerves. It is often benign but can become cancer. It develops from Schwann cells which protect and support the nerve cells.

3. Third-Order Neurons:

Third-order neurons will extend from the side of the neck, spread through the face's skin, and end in the muscles of the iris and eyelids. The medical conditions affecting the nerves of this region are,

  • Damages to the carotid artery and jugular vein along the side of the neck.

  • Migraines - It is a throbbing pounding headache on one side of the head, caused by temporary abnormal activity of the brain vessels and chemicals.

  • Cluster headache - It includes a headache that frequently occurs for some time, resolves, and begins after remission. Abnormality in the body's biological clock is found to play a role.

  • Tumor at the base of the skull.

  • The base of the skull shows signs of infection.

What Are the Symptoms of Horner Syndrome?

  • It affects one side of the face.

  • The affected eye will have a pupil smaller than the normal one.

  • It becomes difficult to view things in the dark because the affected eye's pupil does not dilate or happens slowly.

  • Ptosis (drooping of the upper eyelids) can be noticed.

  • Anhidrosis can be noticed, which means the absence of sweating on one side of the face.

  • The color of the iris may lighten, especially in infants.

  • Flushed faces (one side) can be noticed, especially in children.

  • Involuntary eye movements - nystagmus can be seen.

  • Pain and numbness in the arms.

What All Conditions Can Be Mistaken for Horner Syndrome?

Some conditions can have the same set of signs and symptoms, and it can be confusing. Two of the conditions having similar clinical features to horner syndrome are,

  • Adie Syndrome - Also known as Holmes-Adie syndrome, is a rare neurological disorder characterized by larger pupils than normal and slow dilation of the pupils (resulting in decreased ability to view things in the dark). In certain cases, the affected pupil can be smaller too (mimicking Horner syndrome) and with appropriate tools, an accurate diagnosis can be made.

  • Wallenberg Syndrome - It is a neurological disorder caused by a stroke of the posterior inferior cerebral artery or the vertebral artery. It can be characterized by signs of dizziness, difficulty in swallowing, nausea and vomiting, and nystagmus in addition to ptosis and anhidrosis (signs of Horner syndrome). Thus, Wallenberg syndrome can be confused with Horner syndrome.

How to Diagnose Horner Syndrome?

  • Firstly, a physical examination of the sign and symptoms will be examined. If Horner syndrome is doubted, the patient will be recommended to seek an ophthalmologist.

  • The ophthalmologist will do a dilation test. Horner syndrome will be confirmed if one pupil does not dilate or dilates slower than the normal one. Horner syndrome will be confirmed. Then, a few diagnostic tests like magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, X-rays, blood tests, and urine tests will be asked to be taken, to find out the root cause of the condition.

How to Manage Horner Syndrome?

Treatment for Horner syndrome depends on what is the causative factor. There is no particular treatment modality for curing Horner syndrome. Treating the underlying medical condition can cure Horner syndrome. If the condition is mild and not causing much trouble, it will be left as such.

Conclusion:

Though milder cases of Horner syndrome do not need medical attention, it might be important for the underlying medical condition to be treated. So it is suggested to seek a doctor if signs of Horner syndrome appear and get a proper doctor validation. If it is run in the family, it is better to be aware of the condition and take appropriate steps.

Source Article IclonSourcesSource Article Arrow
Dr. Abhishek Juneja
Dr. Abhishek Juneja

Neurology

Tags:

horner's syndrome
Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Source Article ArrowMost popular articles

Do you have a question on

horner's syndrome

Ask a doctor online

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy