Horner’s syndrome is a relatively rare disease. It can affect infants from birth or it can affect adults. A more rare form of Horner’s syndrome is present at birth but the cause is unknown. Horner’s syndrome is hypothesized to be caused by the interference of the sympathetic nerves that serve the eyes. Other causes include snakebite or a bite from an insect to a neck trauma made by a blunt instrument.
What Is Horner’s Syndrome?
Horner’s syndrome is characterized by drooping eyelids, constricted pupils, inability to produce sweat on the face, and a sinking back of the eyeballs. It is thought to be due to the disruption of a nerve pathway from the brain to the face and eye on one side of the body. Horner’s syndrome can also be the result of another medical problem such as stroke, tumor, or spinal cord injury. There is not any specific treatment for this disorder and each case is treated relative to the perceived cause.
Horner’s Syndrome Symptoms
Horner’s syndrome usually affects only one side of the face. Various symptoms arise as a result of the nerve blockage that is associated with Horner’s syndrome. Difficulty controlling facial expressions or blinking are most commonly associated with this condition.
For children, Horner’s syndrome sometimes produces certain signs and symptoms that should be acknowledged and reported. Horner’s syndrome symptoms in children can include lighter iris color of one eye of an infant or a redness or flushing on the affected side of the face.
Other common symptoms of Horner’s syndrome may include:
- Little or no sweating, known as anhidrosis, on the face.
- Drooping of the upper eyelids, known as ptosis.
- Miosis, or small pupils
- Little or delayed dilation of the affected pupil in dim light.
- A notable difference in the sizes of the pupil in both the eyes, referred to as anisocoria
- Ptosis or slight elevation of the lower eyelid.
- Impaired vision
- Severe or sudden pain
- Lack of muscle control
Horner’s Syndrome Causes
Horner’s syndrome can be caused by an interruption of the nerve fibers that start in the hypothalamus in the brain and travel to the face and the eyes. The interruption of the nerve connection can result from genetics, injury, or medical conditions. In very rare cases the Horner’s syndrome is present at the time of birth. The condition can occur due to a lack of pigmentation of the iris.
Causes of Horner’s syndrome include but are not limited to:
- Injections or surgery done to interrupt the nerve fibers and relieve pain
- Damage to one of the main brain arteries
- A tumor
- Damaged neck nerves
- Lesions on the brain stem or spinal column
- Neurotoxic venom from insects or animals
Physical examination for Horner’s Syndrome
In the physical examination of Horner’s syndrome, eye examination is done. The eye examination may show a red eye, changes in how the pupil opens or closes, or a drooping of eyelid on one part of the face.
Tests for Horner’s Syndrome
There are a number of tests that are done for this rare disease in order to properly diagnose it. Such tests include blood tests, spinal tap, which is lumbar puncture, or MRI or CT scan of the brain. Some other tests can include chest X-ray or chest CT scan and blood vessels test that may include cerebral angiogram, MR angiogram or CT angiogram.
Horner’s Syndrome Treatment
There is no proper treatment of Horner’s syndrome. The disease disappears when the underlying medical condition is treated effectively. In cases of damaged nerves, repairing the nerves or blocking the signals will provide relief. In cases of tumors, removal of the tumor usually leads to full recovery.
Horner’s Syndrome Legal Considerations
Misdiagnosis of Horner’s syndrome can often occur, even amongst professionals. Horner’s symptom can sometimes be misdiagnosed as Bell’s palsy, since one of its symptoms is the drooping of the eye. However, if you or a loved one has suffered from this disease due to birth injury, medical malpractice, or negligence by the physicians as a result of misdiagnosis or lack of effective treatment, then it is important to contact a birth injury lawyer or medical malpractice lawyer to help you seek justice.
“Horner Syndrome.” Horner Syndrome. The Mayo Clinic. Web. 27 Jan. 2015. <http://www.mayoclinic.org/diseases-conditions/horner-syndrome/basics/definition/con-20034650>.
“Horner Syndrome: MedlinePlus Medical Encyclopedia.” U.S National Library of Medicine. U.S. National Library of Medicine. Web. 27 Jan. 2015. <http://www.nlm.nih.gov/medlineplus/ency/article/000708.htm>.
“Horner’s Syndrome.” Rare Diseases. National Organization for Rare Disorders. Web. 27 Jan. 2015. <https://www.rarediseases.org/rare-disease-information/rare-diseases/byID/864/viewFullReport>.