1Horner's syndrome - external manifestations, symptoms
- 1.1Causes and Classification of Horner's Syndrome
- 1.2Signs and symptoms of Horner's syndrome
- 1.3Diagnosis of Horner's Syndrome
- 1.4The methods of treatment of the Bernard-Horner syndrome
- 1.5Therapeutic treatment of Horner's syndrome
- 1.7Prophylaxis of Horner's syndrome, prognosis
2Horner's syndrome is a pathological disorder of the autonomic nervous system
- 2.1Causes of Horner's Syndrome
- 2.2Symptoms and Signs of Horner Syndrome
- 2.3Diagnosis of Horner's Syndrome
- 2.4Treatment of Horner's Syndrome
3Symptoms, Treatment of Horner's Syndrome
- 3.3When to see a doctor
- 3.5First-order neurons
- 3.6Second-order neurons
- 3.7Neurons of the third order
- 3.9Before a visit to a doctor
- 3.11Determination of a damaged part of the neural pathway
4Horner's Syndrome - (Bernard-Horner)
- 4.1Causes of development
- 4.3Diagnosis of pathology
- 4.4Treatment of the syndrome
5What is Horner's syndrome and its features
- 5.2Symptoms of Horner's syndrome in adults and children
- 5.3Methods of diagnosis of the syndrome
- 5.4Treatment of neurological disorders
- 5.5Preventive measures
6Horner's syndrome or oculosympathetic syndrome
- 6.1Forms of Horner's Syndrome
- 6.2Symptoms of oculomotor nerve
- 6.3Causes of Horner's Syndrome
- 6.4How to treat Horner's syndrome
7Horner's syndrome - a violation of the innervation of the sympathetic nervous system
- 7.1Causes of Horner's syndrome: varieties
- 7.2Symptoms of Horner's Syndrome
- 7.3How to treat Horner's syndrome
Horner's syndrome - external manifestations, symptoms
Horner's syndrome is an external manifestation of the disruption of the functioning of the sympathetic nervous system.
It was described in the 19th century by the Swiss ophthalmologist Friedrich Horner, after whom he was named.
Practically simultaneously this syndrome was described by one more doctor - Claude Bernard, therefore very often from doctors it is possible to hear and the double name - a syndrome of Bernard-Horner.
The leading mechanism for the formation of this syndrome is the disruption of normal functioning The oculomotor nerve, which is responsible for opening and closing the eyelids, provides a narrowing and dilated pupils.
Causes and Classification of Horner's Syndrome
On the basis of the causes of the onset, two main forms of this syndrome are distinguished: primary and secondary.
Primary or idiopathic Gorner syndrome is an independent disease, the causes the occurrence of which is not fully understood, and the symptoms appear against the background of relative well-being patient.
Secondary Horner's syndrome develops due to some disease. It should be noted the most common diseases and pathological conditions leading to the formation of this syndrome:
- tumors of the central nervous system - spinal cord and brain;
- Pancoast tumor - localized in the upper third of the lungs;
- trauma to the head and spine, leading to brain damage;
- inflammatory diseases of the cervical spine;
- otitis media;
- stroke or cerebral hemorrhage;
- myasthenia gravis;
- multiple sclerosis;
- exfoliating aortic aneurysm;
- alcoholic or other intoxication;
- an enlargement of the thyroid gland
Bernard-Horner's syndrome can develop as a result of a surgical operation, during which the nervous structures of the sympathetic system were damaged. Extremely rare is the hereditary form of this syndrome.
In newborns, the syndrome can form as a result of some types of obstetric intervention. For example, after rotation of the fetus with an incorrect presentation, when using forceps during labor, as well as as a result of delayed delivery.
Signs and symptoms of Horner's syndrome
The clinical picture of this pathology is quite specific. There are several signs, in the presence of which a diagnosis can be made. For this, two of the following symptoms are sufficient:
- Myos - persistent narrowing of the pupil.
- Ptosis - lowering of the upper eyelid, leading to narrowing of the eye gap.
- Inverted or reverse ptosis is the raising of the lower eyelid, which also leads to narrowing of the eye.
- Enophthalmus is the occlusion of the eyeball in the orbit.
- Heterochromia, which manifests itself in different colors of the iris in humans. It is often noted in newborns. Heterochromia can also be manifested by the unevenness of the iris staining.
- Anhidrosis - a violation of sweating. With Horner's syndrome, anhidrosis is one-sided and affects only the face. There may also be a difficulty in producing tear fluid.
Nonspecific signs are a decrease in photoreaction of the pupil - in a sick person the pupil reacts very badly to light. Another sign of Gorner's syndrome is the enlargement of the blood vessels on the eyeball. As a result, the eyeball has a typical reddish color.
Diagnosis of Horner's Syndrome
If you have at least two of the above symptoms, you can already suspect this pathology. The patient must be examined by an oculist and neurologist, who will make the final diagnosis.
There is a specific test - a "drop of cocaine during which a drug dilating the pupil is injected into the eye (cocaine was used before, so the test is called) atropine or midriacil.
In a healthy person, the pupil is enlarged in response to this, and the patient with Horner's syndrome does not. In addition, the photoreaction is examined, for which the eye is blessed with bright light and the pupil's reaction to it is monitored.
To determine the causes of miosis, a paredrin test is also used.
Further diagnostic measures are aimed at finding out the causes of the development of the syndrome. Apply CT and MRI of the head, spine, ultrasound of the vessels of the head and neck.
The methods of treatment of the Bernard-Horner syndrome
It should be noted that idiopathic form of pathology can pass without any treatment.
In the case of the acquired form, the main task is to identify the disease that caused the syndrome, and treat it.
For the treatment of external manifestations, both therapeutic methods and surgical methods are used.
Therapeutic treatment of Horner's syndrome
With mild symptoms, medications are used that improve the conduction of nerve impulses along the nerves. In addition, neurostimulation is prescribed - an effect on the eye muscles of an electric current.
Good results are achieved by a combination of neurostimulation with kinesiotherapy of the eye muscles.
The effect of electric current gradually leads to the restoration of the contractile function of the muscles, which is accompanied by almost complete correction of ptosis.
Important! Neurostimulation is a rather painful procedure, but only it can restore muscle tone without surgery.
With ineffectiveness of therapeutic methods of exposure, as well as with very pronounced ptosis, surgical intervention is indicated.
Plastic surgery on the eyelids allows you to get rid of cosmetic defects caused by this disease.
Using the operation, you can completely restore the normal shape of the eye gap and give the eyelids the usual position.
Prophylaxis of Horner's syndrome, prognosis
Unfortunately, there are no effective methods of preventing this pathology.
However, with the slightest suspicion of this syndrome, a comprehensive examination should be performed to find the true cause of the pathology.
Early detection and treatment of the underlying pathology can prevent the development of severe form of Horner's syndrome and in some cases lead to its disappearance.
The prognosis for symptomatic treatment is determined by the severity of the underlying pathology and the effectiveness of the method of treatment. The most persistent and effective effects are provided by plastic surgery.
A source: http://polismed.ru/sindrom-gornera.html
Horner's syndrome is a pathological disorder of the autonomic nervous system
In most cases, this clinical sign is associated with certain diseases, but Horner's syndrome has a transient idiopathic form, which is not associated with any known pathologies, and the clinical signs of this form regress independently without carrying out any treatment
Causes of Horner's Syndrome
Horner's syndrome develops due to various pathological processes, the development of which affects Sympathetic pathways at the level of the cervical spinal cord, brainstem and hypothalamus:
- Tumors of the spinal cord and brain
- Injuries to the spinal cord and brain
- Inflammatory processes of the central nervous system
- Inflammatory diseases of the first ribs
- Inflammation of the upper spine
- Hemorrhage in the brain (stroke)
- Various intoxications (more often alcoholic)
- Multiple sclerosis
- Myasthenia gravis
- Neuralgia of the trigeminal nerve
- Inflammation of the middle ear
- Pancostic tumor (located in the area of the apex of the lungs)
- Aortic aneurysm
- Neurofibromatosis (type 1)
- Cavernous sinus thrombosis
- An increase in the size (hyperplasia) of the thyroid in goiter
Symptoms and Signs of Horner Syndrome
There are several quite specific signs that indicate the development of the patient's Horner syndrome. The presence of all the following signs is not necessary, but at least two of them must be present, this is:
- Narrowing of the pupil (Mioz)
- Omission of the upper eyelid, as a result of which the narrowing of the eye gap (Ptosis)
- Elevated lower eyelid (Inverted ptosis)
- Delay of pupillary dilatation - in bright light the pupil narrows, and in dim light on the contrary - it expands. In the presence of this pathological process, the process of pupil dilatation during the transition to a darker room is slowed down
- Westing of the eyeball (Enophthalmus)
- Different color of the iris of the eyes (Heterochromia). With congenital Horner's syndrome, a different color of the iris can be observed on different eyes
- Irregular staining of the iris, in which the color pigment is irradiated unevenly
- In the affected eye there is a decreased production of tears
- On the affected side of the face, sweating is reduced (Anhidrosis)
- Half of the face on the affected side is hyperemic
- From the affected side, the shell of the eyeball (conjunctiva) of a brighter color
In addition, for Gorner's syndrome, the so-called Petit's syndrome is typical - an abundance of dilated blood vessels on the eyeball, which is revealed during an ophthalmologic examination
Diagnosis of Horner's Syndrome
To determine the presence, as well as the severity of Horner's syndrome, the following tests are used:
- A test with a drop of cocaine. When instigating special eye cocaine drops, the norepinephrine reuptake is blocked, as a result of which the pupil dilates. If there is a Horner syndrome, due to a lack of synaptic cleft norepinephrine, the pupil will not expand
- Test with paredrinum (oxamfetamine). This test helps in determining the cause of miosis
- The test determining the delay of pupil dilatation
- X-ray examination, computed tomography, magnetic resonance imaging. These studies are used to identify various pathological entities capable of provoking the development of Horner's syndrome
Treatment of Horner's Syndrome
The treatment of Horner's syndrome is aimed at nervous and muscular stimulation (it is necessary to "make" nerves and muscles work). For this, kinesiotherapy is used in combination with myoy neurostimulation.
The myoi technique of neurostimulation is based on the effect on the affected nerve or muscle by current pulses.
With this stimulation, absolutely all excitable structures are involved (smooth and / or striated muscular cells of the eye apparatus, nerves).
Mioi neurostimulation allows you to work out and prepare for future regular stresses, even lazy and very weak muscles.
This procedure is performed with the help of skin electrodes under the obligatory supervision of the doctor and is quite painful, but in the end the lymphatic drainage and blood circulation significantly improves, the metabolism is activated, and the muscles return to the state of tonus, for further adequate work.
However, after the onset of improvement, in no case should we stop. It is necessary to continue to work on your muscles by yourself. This will help kinesiotherapy.
This therapy includes a specially designed dynamic complex of physiotherapy exercises: respiratory gymnastics, sports and applied games, training on simulators, various mobile games.
A source: http://vlanamed.com/sindrom-gornera/
Symptoms, Treatment of Horner's Syndrome
Horner's syndrome is a combination of signs and symptoms that arise from damage to the neural pathway leading from the brain to the face and eye on one side, right or left.
Usually, this violation is expressed in a decrease in the size of the pupil, sagging the eyelid, and reducing sweating on one side of the face.
Horner's syndrome is a consequence of another health problem (for example, a stroke, a tumor or a spinal cord injury).
In some cases, it is not possible to find the root cause.
Specific methods of treatment do not exist, but the healing of a primary disease can lead to the restoration of normal nerve functioning.
This violation is also known under a different name - Horner-Bernard syndrome.
As a rule, Horner's syndrome affects only one half of the face. Among the main symptoms are:
- chronic narrowing of the pupil (miosis);
- a noticeable difference in size between the pupils (anisocoria);
- slight or delayed opening (narrowing) of the affected pupil when exposed to light;
- sagging of the upper eyelid (ptosis);
- some elevation of the lower eyelid - sometimes this condition is called "ptosis on the contrary
- reduction or complete cessation of sweating on the entire half of the face or on a separate site from the affected side (anhidrosis).
The difficulty of diagnosing Horner's syndrome lies in the fact that some signs (eg, ptosis and anhidrosis) can be of a slightly pronounced nature.
Horner's syndrome in a child can be identified on the basis of two additional symptoms.
- The lighter color of the iris of the affected eye. This symptom is noticeable in children under the age of 1 year.
- Absence of redness (blush) on the affected half of the face. This symptom is manifested in situations usually accompanied by reddening of the cheeks: with physical activity, heat or resulting as a result of emotional reactions.
When to see a doctor
This violation is due to a number of factors. It is important to deliver a timely and accurate diagnosis.
Seek immediate medical attention if signs of Horner's syndrome appear suddenly, occur after an injury, or are accompanied by the following symptoms:
- visual impairment;
- weakness in the muscles or loss of control of the body;
- sudden severe headache or pain in the neck.
The disorder is caused by damage to a certain nerve pathway in the sympathetic nervous system. The latter is responsible for the heartbeat, the size of the pupils, sweating, blood pressure and other functions that allow the body to quickly adapt to changing environmental conditions.
A damaged nervous pathway consists of three groups of cells (neurons).
This part of the nervous path starts with the hypothalamus at the base of the brain, passes through its trunk and reaches the upper segment of the spine. In this fragment of the nervous path, Horner's syndrome can be caused by the following disorders:
- a tumor;
- diseases, leading to loss of the protective envelope of neurons (myelin);
- neck injuries;
- cyst or cavity in the spine (syringomyelia).
This fragment of the nerve path starts from the spine, passes over the upper part of the thorax and ends in the neck. Below are the circumstances that cause in this part of the nerve Horner's syndrome (the causes of the disorder):
- lungs' cancer;
- swelling of the myelin sheath (schwannoma);
- damage to the main blood vessel leading from the heart (aorta);
- surgical operation in the chest cavity;
Neurons of the third order
This part of the nerve path starts in the neck and leads to the skin of the face, as well as to the muscles of the iris and eyelids. The causes of nerve functioning disorders in this case:
- damage to the carotid artery;
- damage to the jugular vein;
- a tumor or infection at the base of the skull;
- severe seizure-like headache with recurrent relapses.
Congenital Horner's syndrome in children is diagnosed if there are:
- damage to the neck or shoulders during childbirth;
- congenital aortic defect;
- tumors of the endocrine and nervous systems (neuroblastoma).
In some cases, the causes of the violation can not be determined, and doctors diagnose Claude Bernard-Horner's syndrome of an unknown genesis.
Before a visit to a doctor
If you do not need urgent medical help, you should start by consulting a therapist or ophthalmologist. If necessary, you will be redirected to a specialist in nervous system disorders (neurologist).
Before visiting a doctor, make a list of the following items:
- signs and symptoms of the disorder (any deviations from the norm) that cause you anxiety;
- past and current illness or injury;
- all medications taken, including over-the-counter medicines and nutritional supplements with dosage indication;
- any significant changes in your life, including the recently experienced stress.
In addition to general medical examination, the doctor will conduct specific studies aimed at identifying the root cause of the symptoms.
First of all, it is necessary to confirm the diagnosis, since the doctor may suspect the development of Horner's syndrome only on the basis of the medical history and own assessment of the symptoms.
An ophthalmologist can confirm the diagnosis by dropping special drops into each eye of the patient either to dilate the pupil or to narrow it.
Reaction to the drug will be observed only in the healthy eye.
By comparing pupillary responses, the doctor can determine if nerve damage is the cause of the classic symptom of Gorner's syndrome.
Determination of a damaged part of the neural pathway
The intensity or nature of certain symptoms, perhaps, will allow a specialist to narrow down the range of diagnostic studies.
Thus, there are special drops that cause a strong dilatation of the pupil in the healthy eye and a slight enlargement in the affected.
The effectiveness of these drops indicates the pathology of third-order neurons.
To determine the specific area at which a nerve function disrupted, the following imaging studies are assigned:
- magnetic resonance imaging (MRI) - a technology that uses radio waves and a magnetic field to produce detailed images;
- computed tomography (CT) - specialized radiographic technology;
In the case of diagnosis of a disorder in the child, the doctor will prescribe urine and blood tests, with which you can identify a tumor of the endocrine and nervous systems (neuroblastoma).
If Horner's syndrome is diagnosed, treatment, as a rule, is not prescribed, since the methods of its treatment have not yet been developed. In most cases, it disappears after the effective treatment of a disease or disorder, which is its original cause.
A source: https://www.syl.ru/article/193306/new_simptomyi-lechenie-sindroma-gornera
Horner's Syndrome - (Bernard-Horner)
Horner's syndrome (sometimes referred to as Bernard-Horner's syndrome) is a disorder of the sympathetic nerves, leading to a disruption of the innervation of the eye muscles. Visually manifested by the lowered eyelid, the narrowing of the pupil, the flowing eye and some other motor dysfunctions.
It occurs equally in people of different ages, can be congenital. In children, Horner's syndrome often leads to a multicolored iris, when one eye of a child has a darker shade, and the other - a light one.
The disease is relatively infrequent, but the treatment is a nuisance to neurologists.
Causes of development
The main reason for the appearance of the Bernard-Horner triad is the total violation of the sympathetic nervous system.
As a rule, the root of the problem is hidden in the medulla oblongata, where the nuclei of neurons that go along the eye canal to the eyes are located.
Due to damage to any parts of the nerve processes, impairment of impulse transmission develops. This leads, in turn, to abnormal innervation of the eye muscles.
To date, there are three groups of causes that can lead to the defeat of these areas of the sympathetic system:
Sometimes Horner's syndrome appears immediately at birth - due to some abnormalities during embryogenesis. However, it should be noted that the congenital type of this syndrome is quite rare.
Much more frequent lesions of nerve fibers due to drug treatment of neurological diseases or surgical intervention (iatrogenic pathway of the syndrome).
The most common pathologies that lead to the acquired form of the Bernard-Horner syndrome are such ailments as:
- head trauma with multiple injuries of internal structures;
- aneurysm of the aorta, especially complicated by phlebotomy;
- various diseases of the thyroid gland;
- malignant tumors localized in the brain;
- severe cluster headaches.
In addition, Claude Bernard-Horner's syndrome can develop due to some rare neuralgic conditions, for example, syringomyelia.
The fundamental symptoms for this disease are the famous triad of Bernard-Horner, which includes such states:
- ptosis (descent, prolapse) of the upper eyelid;
- miosis (abnormal narrowing) of the pupil;
- enophthalmos (sagging of the eyeball).
All three symptoms occurring simultaneously, almost certainly indicate Horner's syndrome.
This affects only one half of the person affected by the effects of the triad.
In addition to the usual motor disorders, there is a violation of sweating and lacrimation, hyperemia and enlargement of small blood vessels.
The narrowed pupil does not react not only to light, but also to different medications. In children, congenital Horner syndrome can lead to heterochromia - due to a violation of the innervation of the eyeball, the iris is poorly pigmented, and the eyes of the child have a different color.
All the symptoms of such a disease as Horner's syndrome are explained by the paresis of the muscles of the eyelid, the iris and the main orbital muscle of the eye.
Diagnosis of pathology
The diagnostic statement of the presence of the Claude Bernard-Horner syndrome in the patient rests on a careful analysis of the causes of the narrowing of the pupil and ptosis of the upper eyelid.
First of all, the doctor needs to use the so-called cocaine test - special drops with a small amount of cocaine sulphate are instilled in the eye of the patient.
The normal pupil on this medication will react with a sharp expansion, and if the affection of Horner's syndrome, the enlargement (midriaz) is not observed.
The use of the oxamphetamine drip test allows one to determine the quantitative degree of sympathetic nerve damage in this syndrome. In this method, eye drops based on amphetamine also dilate the pupil, but only if the third (last) neuron in the innervation of the eye functions normally. Otherwise, it is damaged.
A study of the omission of the eyelid in a disease such as Horner's syndrome is aimed at differential diagnosis in order to exclude the common defeat of the oculomotor nerve.
In Bernard-Horner's syndrome, ptosis has an average or poorly expressed level, sometimes hardly noticeable. The pupil is always narrowed.
And if the oculomotor nerve is damaged, then the omission of the eyelid is quite pronounced, the pupil is greatly expanded.
Further diagnosis is aimed at establishing the main cause of the development of Horner's syndrome in order to correctly prescribe the treatment.
At the same time, the degree of sympathetic neuronal damage is fixed, which affects the further course of treatment.
At this stage of research, computer and magnetic resonance imaging is used.
A detailed video about the symptoms and treatment of this disease:
Treatment of the syndrome
The Bernard-Horner syndrome never leads to death, and in many cases, having rather weak manifestations, almost does not cause discomfort. Active treatment of this disease is carried out only at the stage of progression. There are basically three ways of eliminating the syndrome:
In order to get rid of Horner's syndrome for sure, you need to reliably identify and eliminate the main pathogenic cause that triggered the appearance of this neurological disorder. With mild manifestations of disorders of the sympathetic system, causal treatment is sufficient.
In other cases, neurostimulation using low-voltage currents is used. During the procedure, electricity is passed through the damaged area of the neurons, which stimulates the muscles.
Neurostimulation in this way is quite painful, therefore it should be performed only by a high-class specialist.
Horner's syndrome often leads to aesthetic and cosmetic disorders caused by the paresis of the eye muscles, which is why the help of a plastic surgeon is recommended.
A source: http://prosindrom.com/neurological/sindrom-gornera.html
What is Horner's syndrome and its features
Often when examining and diagnosing various pathologies in the main diagnosis, not one but several diseases are put.
Very many patients turn to neurologists to explain what Horner's syndrome is.
The peculiarity of this disease is the ability, by external signs, to determine its symptoms in a patient.
Neurological disorders cause quite a lot of trouble with their manifestations and complex treatment. One of these diseases, which is characterized by eye damage, is Horner's syndrome.
In science, a physician who discovered a disease is considered an ophthalmologist. F. Gorner, but the description of the disease by other medics existed before him, so at the current time several variants of names are used.
Claude Bernard Horner's Syndrome (Horner's Syndrome or Bernard Horner's Syndrome) is a disease in which one is amazed department of the nervous system, responsible for the emotional state of a person and his readiness for stressful situations. Very often a short term is used to define this department of the nervous system - the sympathetic nervous system.
The main source of the appearance of Horner's syndrome is the breakdown of any part of the sympathetic nervous system.
But according to statistics, the area of the brain most often suffers, which is involved in the work of visual channels.
Nevertheless, we can conditionally deduce three groups of causes of the syndrome:
- congenital pathologies of the sympathetic parts of the nervous system;
- disorders resulting from other diseases;
- provoked by medical procedures or protocol of treatment of the disease.
Nor is Horner's syndrome a frequent congenital disease, a rare phenomenon associated with pathologies that occurred during the embryo formation. And also with complications during childbirth.
The main factors provoking the syndrome in newborns are:
- the application of forceps in childbirth;
- belated births;
- vacuum extraction of the fruit;
- difficulties in the birth of the shoulder;
- congenital varicella;
- trauma and neoplasm of the nasopharynx;
- cytomegalovirus infection;
The most frequent occurrence of the syndrome is observed in the presence of diseases that provoke its development. Usually the nature of such ailments is directly related to the pathology of the central nervous system, but other disorders in the body can trigger the disease, for example:
- inflammatory processes in the nervous system;
- craniocerebral injuries of any complexity;
- endocrine disorders provoked by the thyroid gland;
- aortic aneurysm;
- oncological diseases localized in the brain;
- cluster headache;
- injuries associated with the cervical spine;
- otitis media;
- alcoholic intoxication of a chronic nature;
- inflammation of the trigeminal nerve;
- autoimmune disorders.
There are also cases when the syndrome appears after medical procedures, for example, during a surgical procedure, which was necessary according to the protocol of treatment.
Most often, this occurs in operations on neoplasms in the brain or in the upper parts of the spine.
The nature of this cause of the syndrome in another way is called iatrogenic.
Symptoms of Horner's syndrome in adults and children
In this case, there are accompanying manifestations, such as:
- the state of the eyelid can change - either an upper or a slight uplift of the upper is observed, this state of the eyelids is combined into one term ptosis;
- a weak reaction of the pupil to light;
- severe narrowing of the pupil;
- the eyeball may fall into the orbit;
- on the affected side of the face sweating is violated, there is hyperemia, burst blood vessels on the conjunctiva of the eyes.
Horner's syndrome in newborns and small children gives an unusual color of the iris, so that the eyes can be of different colors due to the lack of a sufficient amount of pigment.
Also, when making a diagnosis, it is necessarily taken into account that the main symptom of Bernard Horner's syndrome is manifestations simultaneously three signs - the so-called triad of Bernard Horner - a combination of ptosis, narrowing of the pupil and sagging of the ophthalmic apple.
By the origin of the lesions of the nervous system it is possible to distinguish conditionally the manifestations of Horner's syndrome.
If the work of the central neuron is broken, then symptoms of other diseases associated with the operation of the brain stem, for which he responds, can be observed.
The defeat of the preganglionic neuron usually occurs with tumor formations in the body. If the carotid artery is disturbed, the postganglionic neuron usually suffers.
Methods of diagnosis of the syndrome
Methods for diagnosing Horner's syndrome boil down to the fact that the main task of the doctor is to determine the nature of the narrowing of the pupil and ptosis. A thorough visual examination of the patient and a study of the medical history are mandatory.
Scheme of conducting samples for diagnosis of the disease:
- Drops based on cocaine sulfate are instilled in the diseased eye in order to test the pupil's reaction. A healthy eye reacts to this drug by dilating the pupil. If there is this syndrome, the pupil will not react;
- amphetamine test - with the help of instillation into the eye drops based on oxamphetamine shows whether the postganglionic neuron is damaged, which will not allow the dilated pupil under the action of another drug;
- check the condition of ptosis, with the syndrome is not characterized by its pronounced manifestation, in contrast to complete inflammation of the oculomotor nerve;
- Checking the response of the eyesight during lighting changes is not the main method of diagnosis, but helps to make a clinical picture.
If the doctor is sure of the diagnosis, the patient is assigned a magnetic resonance imaging to determine the degree of damage to the sympathetic nervous system to select the treatment protocol. Also for the exclusion of other diseases, computer tomography, X-ray of those departments where there may be the presence of formations provoking the appearance of the syndrome can be prescribed.
Treatment of neurological disorders
As in the case of many neurological disorders, the history of the syndrome is not rich in lethal statistics. But in combination with another serious disease, the disease can lead to various complications.
Also in most cases, it manifests itself in a mild form and does not bring discomfort. Active treatment is necessary in cases when the form of the disease progresses. The choice of method of treatment depends on the severity of the manifestation of the syndrome in the patient.
If the elimination of a probable cause does not lead to a positive result, then the narrow profile methods that apply directly to the nervous system are applied.
If necessary, use neurostimulation, which works with the affected muscles with the help of a weak voltage.
Such a procedure should be carried out by a high-level specialist, since the pain effect is pronounced in the course of carrying out.
In case the disease has been aggressive, the patient needs the intervention of a plastic surgeon, since the specificity the disease leads to the defeat of the facial and deformation of the location of the eyeball, and requires a serious correction of appearance patient.
Also, when the disease is actively recommended to use special massages that help stimulate the work of those areas of the sympathetic nervous system in which violations are found.
It should be noted that the disease, with the exception of cases of congenital pathology, is predominantly acquired. Therefore, there is no universal remedy or preventive drugs from it.
As with all the ailments associated with the muscles, you can use home masks to strengthen the affected areas, but it is necessary to get a doctor's advice about the use of certain components to avoid possible deterioration state.
Horner's syndrome requires comprehensive diagnostic measures to identify, carefully examine the history and determine the extent of the disorder departments of the nervous system, since its manifestation and progressive course may indicate the presence of problems of a more serious character. And in the presence of diseases that provoked it, it can lead to complications that pose a serious threat to the body. Therefore, at the first suspicions and appearances of the described symptoms of Horner's syndrome, one should immediately turn to doctor and undergo all necessary examinations, considering all possible illnesses in the anamnesis and hereditary factors.
A source: https://nervivporyadke.ru/tsns/sindrom-gornera.html
Horner's syndrome or oculosympathetic syndrome
Horner's syndrome (or oculosympathetic syndrome) is a pathology of the autonomic nervous system caused by a violation of the sympathetic innervation and accompanied by defeat of the oculomotor nerve, which is responsible for the movement of the eyeball, the pupils' reaction to light and the rise of the century.
The disease itself is not dangerous. But if it indicates a serious pathology, then it requires careful diagnosis and adequate treatment.
Forms of Horner's Syndrome
Oculosympathetic syndrome can be idiopathic and secondary.
In the first case, it develops as an independent disease and is not a consequence of another pathology. Its clinical signs regress independently.
The secondary type of Horner's syndrome, in contrast, is a complication of some other disease.
Symptoms of oculomotor nerve
The following signs testify to the development of the Horner syndrome:
- The appearance of a sensation of the lower eyelid (ptosis) lowering, which is caused by the paralysis of the muscle responsible for its uplift (upper tharsal muscle), and narrowing of the eye gap;
- Diplopia is an ophthalmologic pathology, which manifests itself by the duplication of images and objects falling within the human visual field and is amplified when looking in the direction of a paralyzed internal rectus muscle or when trying to fix a glance at closely located subjects;
- Difficulty of movement of the eye upward and inward, as well as restriction of motor activity when trying to look down. If you want to focus on the closely located objects, the eyeball does not converge (does not deviate to the middle);
- Pathological narrowing of the pupil on the affected side (miosis);
- Weak intensity of direct and friendly reaction of the pupil to light, caused by the pathology of the pupil sphincter;
- Heterochromia - a different color of the iris of the eyes or uneven coloring. This symptom develops in children with a congenital form of Horner's syndrome. Its cause is the absence of sympathetic innervation and, as a consequence, the absence of melanin pigmentation of melanocytes in the stroma of the iris;
- Reduced tear of the eye on the affected side;
- Visual impairment at a close distance from the affected side due to paralysis of accommodation;
- Loss of tonus of the external muscles and as a result of this, exophthalmos (protrusion of the eye);
- A large number of dilated vessels in the eyeball, which is revealed when viewed from an ophthalmologist;
- Violation of sweating on the affected side of the face (dyshidrosis);
- Delayed enlargement or narrowing of the pupil;
- Redness of the face from the affected side.
It should be noted that a patient with Horner's syndrome may not have all of the above symptoms. But for the diagnosis to be identified and confirmed by special samples at least two.
The most common symptoms of the oculosympathetic syndrome are the omission of the upper eyelid (rarely - the raising of the lower eyelid), the narrowing of the pupil and its weak reaction to light stimulation.
Causes of Horner's Syndrome
The syndrome most often develops due to some pathological process in the body, it can also be congenital or acquired as a result of surgical intervention. The most common reasons for Horner's syndrome include:
- Inflammatory processes affecting the central nervous system;
- Neoplasms in the spinal cord or brain;
- Tumor of the upper lung sulcus (Pancoast tumor);
- Inflammatory processes, as a result of which the first ribs and / or the upper parts of the spine are affected;
- Trigeminal neuralgia;
- Craniocerebral injury;
- Injuries to the spinal cord;
- Multiple sclerosis;
- Inflammatory processes in the middle ear;
- Aneurysm of the aorta;
- Paralysis Klumpke;
- Alternating syndromes;
- Thrombosis of the cavernous sinus, etc.
The main causes of Horner's syndrome in newborns are:
- Use of forceps for obstetric aid;
- Difficulties in the birth of the shoulder;
- Late births;
- Vacuum extraction of the fruit;
- Birth trauma.
In the works of some authors, cases of the connection of Horner's syndrome in newborns with the syndrome of congenital varicella are described. The explanation for this may be that the smallpox virus provokes radiculopathy, which in turn leads to a disruption in the development of the upper limb.
Also, the development of Gorner's syndrome in newborns can result in injuries, neoplasms in the nasopharynx and in the central nervous system, heredity, agenesis of the internal carotid artery and cytomegalovirus infection.
How to treat Horner's syndrome
Before choosing the optimal treatment regimen for this disease, the patient is recommended to undergo a series of diagnostic tests.
To begin with, drops with cocaine hydrochloride can be prescribed.
If we are talking about Horner's syndrome, the eye reacts to the introduction of the solution with anisocoria (the pupils become different in size).
This is due to the fact that the production of norepinephrine provokes the dilatation of the pupil of a healthy eye, in a diseased eye this effect does not develop.
The next method of diagnosis is the instillation of an M-holinoblocker solution in both eyes. The result of the test with oculosympathetic syndrome is the same as in the first case.
For diagnostic purposes, an oxymphetamine test can be used to detect the third sympathetic neuronal lesion. Often an investigation is made to delay the pupil's reaction to light (a beam of light is sent to the eye with an ophthalmoscope).
In cases where Horner's syndrome is an independent disease, and not a complication of another pathological process, it does not pose a health risk to the patient and does not require treatment.
How to treat Horner's syndrome in the case when it is acquired character, completely depends on the underlying disease. To begin with, the cause is accurately diagnosed, and then the optimal treatment regimen is selected.
A source: http://zdorovi.net/bolezni/sindrom-gornera.html
Horner's syndrome -violation of the innervation of the sympathetic nervous system
Horner's syndrome in medicine is called clinical syndrome, which is characterized by a violation of the innervation of the sympathetic nervous system of man.
This disease manifests itself, first of all, by the defeat of the oculomotor nerve, which provides expansion and contraction of the pupils, and also allows the eye to open and close. That is why this pathology leads to a change in one of the pupils and to the omission of the eyelid.
In most cases, Horner's syndrome occurs due to certain diseases, acting as an additional symptom of any disease.
Causes of Horner's syndrome: varieties
There are two types of Horner's syndrome: primary and secondary. The primary, or idiopathic, species is an independent pathology that is not a consequence of any disease.
All clinical signs in this case regress themselves. Secondary form is the result of a particular disease.
In this way,can identify a number of common causes of the Horner syndrome:
- Tumors of the spinal cord and brain;
- A tumor in the upper part of the lungs (the so-called Pancoast tumor);
- Various injuries of the brain and spinal cord;
- Inflammatory diseases of the first ribs;
- Inflammatory processes of the upper spine;
- Inflammatory diseases of the central nervous system;
- Inflammation of the middle ear;
- Hemorrhage in the brain (stroke);
- Neuralgia of the trigeminal nerve;
- Multiple sclerosis;
- Aneurysm of the aorta;
- Myasthenia gravis;
- Hyperplasia of the thyroid gland in goiter;
- Various intoxications (for example, alcoholic).
MedicineThere are some cases when the cause of the Gorner syndrome was surgical intervention, after which the pathology developed. Very rarely it can also be inherited.
In children, this disease is rare: only 2 cases per 100 000 babies. However, it should be noted that Horner's syndrome in newborns is not always a congenital pathology. In almost half the cases, it is the result of surgical intervention.
The most common cause in such situations is the rotation of the fetus, difficulty in the birth of the shoulder, delayed delivery and the use of forceps during obstetric care.
The last factor (application of forceps) in some cases provokes the appearance of Horner's syndrome in newborns due to dissection of the internal carotid artery of the child.
Symptoms of Horner's Syndrome
Symptoms of Horner's syndrome are quite specific, therefore it is easy to determine the presence of this pathology in humans. It is not necessary that all the signs are present, but the presence of at least two of them already speaks about this disease. Consider the main symptoms of the syndrome:
- Inverted ptosis;
Myosis in medicine is called narrowing of the pupils, and ptosis is the lowering of the upper eyelid, which provokes narrowing of the eye's slit. Also, patients may have an elevated lower eyelid or inverted ptosis.
Enophthalmus is a westernization of the eyeball, which is a common symptom of pathology. Horner's syndrome in newborns can often manifest through heterochromia - a different color of the iris of the eyes. It is also often observed its uneven staining in patients.
Anhidrosis in this disease is a symptom that partially prevents normal sweating on the affected side of the face. In addition, the process of producing tear fluid is disrupted.
With Gorner's syndrome, vasodilation of the eyeball is often observed, and the pupil's reaction to light.
In a healthy person under strong light, the pupil narrows, and in the dark, on the contrary, expands, whereas in patients who are prone to this pathology, this process is significantly slowed down.
How to treat Horner's syndrome
In order to know how to treat Horner's syndrome, you must first make sure of the diagnosis and determine the severity of the disease. To date, there are several basic tests, with the help of which the presence of this pathology in humans is established:
- A test with the help of an ophthalmoscope, which reveals a delay in the dilatation of the pupils;
- Test with paredrin, helping to determine the cause of the miosis;
- Test with cocaine eye drops: when they are instilled in healthy people, the norepinephrine reuptake block is blocked, which contributes to the dilatation of the pupil.In the presence of Horner's syndrome there is a shortage of norepinephrine, in connection with which expansion does not occur.
- The test with the instillation in both eyes of the M-cholinoblocker solution, which reveals the syndrome by the same principle as the previous test.
It should be noted that the idiopathic form of the syndrome, as already mentioned above, can pass by itself, so it does not require special treatment.
Acquired the same clinical syndrome, which resulted from a disease, on the contrary, involves thorough diagnosis and subsequent treatment.
In fact, despite the fact that pathology in itself does not pose a serious threat to human health, the cause of its development can not be ignored.
Therefore,to know how to treat Horner's syndrome, it is necessary to establish a disease that provoked it, and begin to eliminate its consequences.
Along with this, two main methods are used to treat pathology: plastic surgery and neurostimulation. The first method is aimed at plastic correction of the expressed cosmetic defects accompanying this disease.
If you turn to professional surgeons, it is possible to restore the correct shape of the eye gap and eyelids.
Neuro-stimulation also means affecting the affected nerve and muscle with current pulses that send special electrodes applied to the skin.
Such a procedure is able to restore and prepare for the next regular load even very weak muscles.
It should be noted: in spite of the fact that neurostimulation is rather painful, it is the most effective a remedy for Horner's syndrome, as it improves blood circulation and metabolism, returning the muscles needed tone.
A source: http://pigulko.ru/sindrom-gornera.php