Anatomical Basis of Horner's Syndrome
Diagnostic Approaches: Anatomical localization of the lesion
Horner's syndrome results from disruption of the sympathetic nervous system, leading to ptosis, miosis, and anhidrosis. Identifying the lesion’s anatomical location is critical for diagnosis.
Anatomical Basis of Horner's Syndrome
Understanding Horner's Syndrome
Horner's syndrome is a neurological disorder caused by disruption of the sympathetic nerve pathway. It manifests as ptosis, miosis, and anhidrosis due to impaired autonomic control.
Diagnostic Approaches: Anatomical Localization of the Lesion
Sympathetic Nervous Pathway
The sympathetic pathway responsible for ocular functions originates in the hypothalamus and descends through the brainstem, spinal cord, and superior cervical ganglion before reaching the eye. Lesions at different levels lead to specific presentations of Horner’s syndrome.
Common Causes and Clinical Evaluation
- First-order neuron lesions: Stroke, tumor, or trauma in the brainstem.
- Second-order neuron lesions: Tumors (e.g., Pancoast tumor), neck trauma.
- Third-order neuron lesions: Carotid artery dissection, cavernous sinus pathology.
Diagnosis and Imaging
Clinical testing includes pharmacological pupil response tests with apraclonidine or cocaine drops. Imaging studies like MRI and CT scans help localize lesions.
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