Horner Syndrome

Horner syndrome known as outlined Claude-Bernard-horner syndrome. by the cervical sympathetic cervical sympathetic nerve damage caused the paralysis syndrome. Cause pathogenesis one. Neck and mediastinal lesions : neck and upper extremity injuries, neck deep shot, stabbed clavicular fractures, Shoulder Dislocation, clinics process of star sympathectomy, sympathectomy. Sympathetic closed for procaine, carotid angiography and arm from nerve damage. Neck cancer, tuberculosis, cancer, lymphoma, lymphadenitis, cervical spinal tumor, esophagus, thyroid and mediastinal tumor, subclavian artery, carotid artery and aortic aneurysms, blood clots in the neck. Apical pleurisy, pneumothorax, pulmonary apex pneumonia, lung, cervical rib, and so on. 2. Myelopathy : syringomyelia, spinal cord hemorrhage, primary or metastatic spinal tumors, multiple sclerosis, cervical spondylosis, Spinal tuberculosis, myelitis or anterior horn polio, syphilitic myelopathy. 3. Skull base : foramen ovale, oval hole injection of alcohol, brain tumors, brain trauma, trigeminal rhizotomy Labor Day, the petrous bone-yim, trigeminal nerve herpes zoster. 4. Intracranial lesions : vertebral artery is not completely blocked, and the medulla and spinal cord vascular lesions, empty medullary syndrome, medullary cancer, encephalitis, multiple sclerosis. These lesions damage to the central sympathetic facial sympathetic eye on the three fiber pathway neurons or fiber, so sympathetic palsy, produce a series of symptoms. Clinical manifestations Miosis, light reflex still exist; Fissile small eyes, slightly drooping eyelid and lower eyelid mild rise; Eyeball depression; No aspect of the disease Khan. Differential diagnosis of lesions decided the key to reducing dependence on the extent of the pupil's observation, significantly narrowed lesions located in the central ridge of eyelashes (C8 under lateral spinal column). Only pupil who was particularly prevalent in the narrow neck of the sympathetic lesion. Sympathetic different time available for damage to eye drug under the pupil to identify the changes. Table 13 -1. No. 13 -1 different neurons damage drugs on the role of pupil damage neurons in the first part of the second neuron third Neurons (box) (pre) (Labor Day) 4% liquid cocaine + +--0.1% epinephrine liquid-- + + + " + "pupil to expand," - "No change eye drops : 4% cocaine droplets into the cul-de-sac, three minutes, a total of three times, 15 minutes after the observation of the pupil : 0.1% drop of adrenaline into the cul-de-sac, three minutes, A total of three 45-minute observation after pupil. 2, eye reflex supine short break after each test the pulse of a few minutes, with eyes closed, reuse finger side of the oppressed eyeball 20 ~ 30 seconds and then measured the pulse of a few. Normal every 10 minutes to slow down ~ 12 times / hours. Vagus nerve tensions were slower increase in the number of vagal nerve palsy without a reaction. Sympathetic tension does not slow down, or even accelerate, their reflex arc for the introduction of the trigeminal nerve center of the medulla oblongata, came out of the vagus nerve. 3, the carotid sinus reflex patients lying or sitting, calm after the first test pulse every few minutes, head slightly to wish the oppression of the contralateral, It jaw slightly raised, in patients who check behind fingers oppression carotid artery branches Department (equivalent to 1 on the sternocleidomastoid muscle / 3), gradually from the front to cervical transverse direction of oppression, repression corresponds to 5 ~ 30 seconds gradually increase finger pressure. Then a few pulse. Slow down the normal 6 -10 times / hours reflex sympathetic to enhance Vice note hyperthyroidism. This reflex arc came to glossopharyngeal nerve center located in the medulla oblongata, came out of the vagal nerve and sympathetic. Attention to the oppression of both sides to avoid simultaneous carotid sinus, sensitive person can cause a sharp drop in blood pressure, syncope, seizures, or even cardiac arrest. 4, skin scratch response with smooth stone Stephen blunt the skin is a line, a few seconds after the first white-lines. After the Red Stripe into a normal reaction. Crossed as a white stripe than continuing to sympathetic activity increased; If uplift even wider stripes, Deputy sympathetic excitatory or increased sympathetic nerve palsy.