Horner-Bernard Syndrome

February 8, 2017

Horner’s syndrome is a nerve disorder that affects a person’s eye. It causes the eye to droop, constricts the pupil, and reduces sweating in the affected area. Horner’s syndrome can occur on its own or as a consequence of other diseases or conditions, including birth injuries caused by trauma during delivery.

Horner’s syndrome is a disorder that affects the sympathetic nervous system. It is a combination of indications and symptoms linked to damage to the nerves that connect the brain to the eyes. Also known as oculosympathetic palsy, Horner syndrome, or Claude Bernard-Horner syndrome, it may occur independently or as a result of another condition, such as a tumor, middle ear infection, a stroke, or syringomyelia (a cavity or cyst in the spinal column).

Horner’s syndrome can also be caused by trauma to the neck. It can develop in adults and children. In neonatal cases, Horner’s syndrome may sometimes be a result of something congenital. However, a birth injury to the sympathetic nervous system during delivery can result in an occurrence of Horner’s syndrome in a newborn infant, and accounts for hundreds of Horner’s Sydrome cases each year in the United States.

Causes

Horner’s syndrome may really be a congenital (present at birth) genetic condition. The condition may be accompanied by a lack of pigmentation of the Iris (colored region of the eye). This is especially true for sufferers of Neurofibratosis, a genetic condition that gives rise to the development of small tumors or lesions on diverse parts of the spine. When these affect the cervical spine, Horner’s Syndrome can arise as a consequence.

Although Horner’s syndrome may occur on its own, it usually is a result of other medical conditions affecting the sympathetic nervous system. The most common triggers of Hunter’s syndrome include –

  • Cluster headaches
  • Damage to the carotid artery
  • Damage to the aorta
  • Damage to the jugular vein
  • Migraines
  • Schwannoma (tumor in the myelin sheath)
  • Thoracic surgery
  • Lung cancer
  • Traumatic injuries
  • Goiter
  • Neck trauma
  • Myelin loss caused by various diseases
  • Tumors

In children, Horner’s syndrome can be caused by –

  • Injury to the neck and/or shoulders during delivery
  • Congenital defect of the aorta
  • Neuroblastoma (tumor of the hormonal and nervous system)

In some instances, it is not possible to trace Horner’s syndrome to a specific cause.

Symptoms

Symptoms of Horner’s syndrome include –

  • A pupil that is smaller than the pupil of the other eye and does not dilate (enlarge) in dim light
  • Ptosis of the eyelid on the affected side of the face
  • Inverse ptosis (i.e., a raised lower eyelid)
  • Sunken appearance of affected eye
  • A large area of skin that does not perspire on the affected side of the face (anhydrosis)

In small children, Horner’s syndrome can sometimes present additional symptoms –

  • The skin on the affected side of the face may not flush (redden) under conditions that would normally cause flushing (e.g., physical exertion, heat, or emotional stress). In some cases the reverse may occur—the affected side of the face will have a perpetually flushed appearance.
  • The iris of the affected eye may have a lighter color than the unaffected eye (especially in cases of congenital Horner’s syndrome).

Complications

Horner’s syndrome does not cause any complications of its own. However, when it is triggered by another disease, such as brachial plexus, there will be complications from either the underlying cause or its treatment.  In addition, although there are no treatment options specifically for Horner’s Syndrome, treatment for the underlying cause of the condition usually helps to clear it up. In instances in which no underlying issue is found, Horner’s Syndrome almost always clears up without much incidence.

Treatment

The condition is often short-lived and does not necessarily need cure. Horner’s Syndrome itself does not have any cure. Treatment of Horner’s Syndrome depends on the cause of the disease. Fortunately, the resolution of the condition is often possible when the underlying cause is cured.

If the difference in size of pupil in each eye becomes a cause of concern, eye drops can be used. Inserting tubes in the ears and using antibiotics can help cure problems like chronic ear infections. In some cases, underlying causes such as multiple sclerosis reject treatment and lead to a permanent or semi- permanent of Horner’s syndrome. However, presence of any incurable condition or potentially recurring disorders like Neurofibratosis may lead to persisting cases of Horner’s Syndrome.

Posted in NEUROVASCULAR