Overview
Horner syndrome is a condition that affects the face and eye on one side of the body. It is caused by the disruption of a nerve pathway from the brain to the head and neck. The syndrome typically presents with decreased pupil size, a drooping eyelid, and decreased sweating on the affected side of the face. Horner syndrome may be a result of another medical problem such as a stroke, tumor, or spinal cord injury, or in some cases, no underlying cause can be found (idiopathic Horner syndrome). Treatment for Horner syndrome primarily focuses on addressing the underlying cause, if identified, as there is no specific treatment for the syndrome itself.
Understanding the disease
Symptoms
Horner syndrome is a condition characterized by a group of symptoms related to the autonomic nervous system. The primary symptom is a "drooping eyelid" or ptosis, often accompanied by a smaller pupil (mydriasis) and decreased sweating (hypothermia) on the affected side of the face. Other symptoms may include mild facial sweating, a flushed or reddened face, and a decreased ability to feel touch (hypesthesia) on the affected side.
Development
Horner syndrome develops due to disruptions in the nerve pathway from the brain to the head and neck. The sympathetic nervous system is affected, leading to issues such as decreased pupil size, drooping eyelids, and decreased sweating on the affected side of the face. Causes of Horner syndrome include stroke, tumor, spinal cord injury, neck trauma, cysts in the spinal column, and injuries during delivery. In children, causes may include neuroblastoma, a defect in the aorta, or unknown reasons. The symptoms can be subtle and may include ptosis (drooping eyelid), anhidrosis (little or no sweating), and differences in pupil size or color.
Assessment and Diagnosis
Triage
You should see a doctor if signs or symptoms associated with Horner syndrome appear suddenly, after a traumatic injury, or are accompanied by other signs or symptoms such as impaired vision, dizziness, slurred speech, difficulty walking, muscle weakness, or severe, sudden headache or neck pain. Prompt medical attention is essential to determine the underlying cause and provide appropriate treatment.
Diagnosis
To diagnose Horner syndrome, your doctor will likely conduct a general medical examination and perform specific tests. They will assess your symptoms and may use eye drops to compare the reactions of your healthy and affected eye. Your doctor may also order imaging tests such as MRI or CT scans to locate the site of nerve damage. There's no specific treatment for Horner syndrome, but it often goes away when the underlying medical condition is treated effectively.
Management and Treatment
Preparing for medical consultation
To prepare for an appointment for Horner syndrome, you should:
- Note any previous medical treatments related to the condition or any other health issues.
- Be aware of any pre-appointment restrictions, such as specific tests or procedures that require preparation.
- Write down your symptoms, including when they began and any changes or worsening over time.
- Compile a list of all medications, vitamins, or supplements you're taking, including dosages.
- Gather information about your family medical history and other relevant health conditions.
- Take a family member or friend with you for support and to help remember important information.
- Prepare a list of questions to ask your healthcare provider. Some basic questions include:
- What's the most likely cause of my Horner syndrome?
- What tests do I need to confirm the diagnosis?
- What are the treatment options available for Horner syndrome?
- Are there any lifestyle changes or medications that can help manage the symptoms?
- Is there a possibility of long-term complications, and how can they be addressed? Remember to also discuss any concerns or questions you have during your appointment. Your healthcare provider will be able to provide guidance and support based on your specific situation.