Dx code for miotic pupil11/7/2023 Carotid artery dissection/ carotid artery aneurysm/trauma.An episode of Horner's syndrome may occur during a migraine attack and be relieved afterwards.Cluster headache - combination termed Horton's headache.Trauma - base of neck, usually blunt trauma, sometimes surgery.Bronchogenic carcinoma of the superior fissure ( Pancoast tumor) on apex of lung.Cervical rib traction on stellate ganglion.Central (anhidrosis of face, arm and trunk).Ĭauses can be divided according to the presence and location of anhidrosis: Although most causes are relatively benign, Horner's syndrome may reflect serious disease in the neck or chest (such as a Pancoast tumor (tumor in the apex of the lung) or thyrocervical venous dilatation). In rare cases, Horner's syndrome may be the result of repeated, minor head trauma, such as being hit with a soccer ball. Horner's syndrome is usually acquired as a result of disease, but may also be congenital (inborn, associated with heterochromatic iris) or iatrogenic (caused by medical treatment). Causes Scheme showing sympathetic and parasympathetic innervation of the pupil and sites of a lesion in Horner's syndrome. In veterinary medicine, signs can include partial closure of the third eyelid, or nictitating membrane. ![]() This happens because a lack of sympathetic stimulation in childhood interferes with melanin pigmentation of the melanocytes in the superficial stroma of the iris. In children, Horner's syndrome sometimes leads to heterochromia, a difference in eye color between the two eyes. The pupil's light reflex is maintained as this is controlled via the parasympathetic nervous system. Sometimes there is flushing on the affected side of the face due to dilation of blood vessels under the skin. The phenomenon of enophthalmos is seen in Horner's syndrome in cats, rats, and dogs. The ptosis from inactivation of the superior tarsal muscle causes the eye to appear sunken in, but when actually measured, enophthalmos is not present. Patients may have apparent enophthalmos (affected eye looks to be slightly sunken in) but this is not always the case. It inactivates the superior tarsal muscle which produces ptosis. It inactivates the dilator muscle and thereby produces miosis. Interruption of sympathetic pathways leads to several implications.
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