BOF: 2.23
A 45-year-old female presents with
a history of headache. She has had a thyroidectomy in the past.
On examination she has a partial
ptosis on the right, enophthalmos on the right side, the right pupil is
smaller than the left and the cilio-spinal reflex is absent on the right hand
side. Her vision is unimpaired, visual fields are normal and eye movements are
full with no diplopia.
The lesion described is:
a)
Third nerve palsy
b)
Holmes-Adie pupil
c)
Horner’s syndrome
d)
Grave’s ophthalmopathy
e)
Myasthenia gravis
Answer:
c)
Horner’s syndrome
consists of partial ptosis, enophthalmos, small pupil, absent
cilio-spinal reflex and absent sweating on the side of the lesion.
Causes:
The causes of Horner’s syndrome
are:
Cerebral lesions:
Massive cerebral infarction
Herniation of the temporal lobe
Brain stem lesions:
Pontine glioma
Lateral medullary syndrome
Cord lesions:
Syringomyelia
Cord tumours
Chest lesions:
Pancoast tumour
Apical tuberculosis
Aortic aneurysm
Neck lesions:
Congenital
Cervical rib
Thyroid, laryngeal surgery
Cervical sympathectomy
Brachial plexus trauma
Neoplasms
Carotid artery aneurysm
