Heterochromia Iridis in Congenital Horner's Syndrome
Department of Neurology, CHU Nîmes, Hôpital Caremeau, Nîmes, France.European Neurology (Impact Factor: 1.36). 04/2010; 63(4):253. DOI: 10.1159/000276946
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ABSTRACT: Purpose Congenital Horner syndrome (CHS) is an ocular condition present since birth as the consequence of birth trauma and brachial plexus injury (interruption of oculosympathetic nerve pathway). Typical clinical signs include heterochromia iridis, miosis, and ptosis. The purpose of this study is to discuss the necessity of imaging methods in diagnosing and appropriate treatment of unrecognized CHS in adults. Design Retrospective observational case report. Case Herein, we present a case of previously unrecognized CHS in a 39-year-old patient with moderate monolateral ptosis. Clinical examination showed besides moderate monolateral ptosis, miosis and heterochromia iridis. Imaging examinations excluded compression etiology of the pathologic condition and the patient was diagnosed to be affected by CHS. Subsequently, the patient was successfully treated with Fasanella–Servat operation. He had a tarsal plate height more than 10 mm and gained long-lasting satisfactory functional and esthetic outcome. Conclusion In cases of adult monolateral ptosis, we have to suspect on unrecognized CHS, where good clinical history (history of delivery injury, comparison of old patient’s photographs) may be determinant in posing the correct diagnosis without subjecting the patient to many invasive and expensive diagnostic procedures. Further, this case confirms that Fasanella–Servat operation may give good functional and esthetic results even in adults with ptosis of different severity.Spektrum der Augenheilkunde 11/2012; 26(5):257-259. DOI:10.1007/s00717-012-0123-8 · 0.18 Impact Factor
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ABSTRACT: A 37-year-old woman presented with papillary thyroid cancer as a complication of prior chest and neck radiation to treat a posterior mediastinal ganglioneuroblastoma, for which the patient underwent surgical resection as a child. The ganglioneuroblastoma obliterated the left second intercostal space and extended into the neck along the sympathetic chain, which was transected during resection, producing postoperative Horner’s syndrome. Additional late-onset complications of radiation treatment included mild aortic stenosis.Physical exam revealed heterochromia iridis (Fig. 1), ptosis, and anisocoria. The patient also noted the absence of left facial and arm flushing with heat exposure, exercise, or consumption of spicy foods.Fig. 1The patient’s affected left eye was different in color, with subtle pupil asymmetry and ptosis.Horner’s syndrome produces the triad of ptosis, miosis, and anhidrosis due to damage to the ipsilateral sympathetic chain. The differential diagnosis is broad but sho ...Journal of General Internal Medicine 04/2015; DOI:10.1007/s11606-015-3293-7 · 3.42 Impact Factor
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