Horner's Syndrome

Aetiology

Associated clinical findings:

• Transient Horners; comes and goes
• Severe headache, with rhinorrhoea and excessive tear production

• weakness, sensory deficit, homonymous hemianopia, diplopia, or ataxia
• No sensory or motor level (instead, hemiplegia)

• Contralateral pain and temperature sensory loss
• Ipsilateral facial sensory loss
• Ipsilateral nystagmus
• Dysphagia
• Ipsilateral V, IX and X cranial nerve lesions

• An associated sixth nerve palsy
• Everything in the cavernous sinus may have been taken out (that being upper facial branches of the 5th nerve, the 4th nerve and the 3rd nerve)

• Dysphagia
• Nystagmus
• Pharyngeal and palatal weakness
• Asymmetric weakness and atrophy of the tongue
• Sensory loss involving primarily pain and temperature senses in the distribution of the trigeminal nerve

• Bilateral signs!
• Dissociated sensory loss: lost pain and temperature sensation, but preserved light touch, vibration and proprioception
• Cape-like distribution of pain
• Hand weakness
• Bowel and bladder incontinence, sexual dysfunction

• Weakness, sensory deficit; with a distinct sensory or motor level
• No diplopia or hemianopia

• Wasting of small muscles of hand and clubbing
• Cervical and axillary lymph nodes

• Suprasternal mass, goitre
• Thyroid bruit
• Cervical and supra/infraclavicular lymph nodes
• Signs of retrosternal goitre, eg. stridor

• Various scars, signs of head / neck surgery/trauma (it wouldn't be subtle)

• Motor deficit isolated to the affected arm
• Weakness in all median and ulnar innervated hand muscles
• Weakness in radial innervated distal forearm and wrist muscles.
• Sensory loss in the medial aspect of the arm, forearm and hand

• Sudden onset of the syndrome
• Pain of the neck or face
• A carotid bruit which is unilateral