[derelys9]

I wasn't quite sure where exactly to post this question, so if it's in the wrong spot I apologize.

I am looking for any information at all about Horner's Syndrome. I've done an online search and found some really good and interesting information, however, if anyone here has any first hand information I would really appreciate it. I know of a one year old child who has been diagnosed with Horner's and am curious as to what can be done for it medically. I am in no way involved in this child's care (the child is being seen by a holistic practitioner in conjunction with a MD) and am quite interested in any information from someone who has seen patients with this before, or if anyone can point me to another place online to find more indepth information.

Thanks

[DDRN4me]

try the nord website (national organization of rare diseases ) i believe it is NORD.org..or google it. Mary

[Jasmine777]

Hi there! I have no first hand experience with this syndrome but I can suggest a good online source: www.eMedicine.com I use it all the time to look up things.
For all of you out there who don't know what Horner's Syndrome is (just like I had no clue ) -- "Horner syndrome refers to a constellation of signs produced when sympathetic innervation to the eye is interrupted.
Signs found in all patients, regardless of the level of interruption include mild-to-moderate ptosis owing to denervation of the sympathetically controlled Müller muscle, slight elevation of the lower lid (upside-down ptosis) due to denervation of the lower lid muscle analogous to Müller muscle in the upper lid, and miosis and dilation lag, where pupillary dilation after psychosensory stimuli is slower in the affected pupil than the unaffected pupil."

[walkiez]

Horners Sydrome is often caused by epidurals. I had a thoracic nerve block in April this year and ended up with a funny eye for a few days. I couldnt even tell there was something wrong with it, friends and family however always said "umm...your eyes looking a little funky...".

It results in ptosis (drooping upper eyelid), miosis (constricted pupil), and occasionally enophthalmos (the impression that the eye is sunk in) and anhidrosis (decreased sweating) on one side of the face, loss of ciliospinal reflex and blood shot conjunctiva (http://en.wikipedia.org/wiki/Horner's_syndrome.

Not too sure what can be done for congenital Horner's.

[derelys9]

Thanks for the links! I'll be sure and pass on the information to the HHP who is trying to help treat this child.

[Wave]

I'm still only a nursing student, but this is right up my alley. My current job is working with a neuro-ophthalmologist. While we don't see this everyday, (and we don't see pedi pts), we do see a fair amount this, along with other people sent over from neurology/ other eye doctors for consultation for other pupil problems. It should be noted that 10% of the population has anisocoria (unequal pupil sizes). It is considered physiologic if < 1mm, or essential (i.e. benign) if >1mm but drug testing doesn't uncover a defect.Typically, once Horner's is confirmed, that's it. No big whoop. If it was not congenital than we refer back to the appropriate service to treat the underlying cause/disease.
I always get a kick out of calling down to the pharmacy to order the testing gtts, which are a 10% cocaine solution. Everybody around me and on the other end of the phone just stops what they're doing and stares at me! Complete stunned silence! LOL

From one of my reference books:
"Sympathetic pupil defects
Sympathetic pupil defects have increased anisocoria in dim illumination. Because of the iris dilator muscle is defective, the smaller pupil is the abnormal one. It stays small when a it should enlarge, because the radial muscle fibers that should contract to enlarge the pupil cannot because they are paretic. Called Horner's Syndrome, this is the only situation in which a pupil defect is caused by a sympathetic pathway. Several defects are caused by the parasympathetic pathway.

Horner's Syndrome
This may result from a lesion anywherein the sympathetic nervous system. It is usually unilateral. Characteristics are:
1. Miosis because the iris dialtor does not contract.
2. Ptosis from lack of tone in Mueller's muscle.
3. Anhydrosis (absense of sweating on th eface and neck) on the involved side from affected sympathetic fibers from the external carotid plexus.
If sweating is intact, then the sympathetic fibers traveling with the external carotid arteries are intact, suggesting Horner's syndrome with 3rd neron (postganglionic) damage, because a central or preganglionic Horner's syndrome effect would destroy the sympathetic fibers before they branch off to the external carotid arteries." *
Here's a good link that explain's Horner's and also talks about testing to confirm Horner's and determine where the problem area is. In particular I think that the OP will find the second paragraph of interest:
http://www.revoptom.com/HANDBOOK/sect6g.htm
and there are some pictures at this site under neuro-ophthalmology:
http://www.redatlas.org/main.htm



* from: Fundamentals for Ophthalmic Technical Personnel by Barbara Cassin. Published by W.B. Saunders Co. page 172