How to Work Up Horner Syndrome

In this 1-Minute Video, Dr. Vivek Patel reviews the neurobiology behind Horner syndrome. Physicians quickly consider this disease when observing a combination of miosis, anhidrosis and ptosis, but Horner can be caused by an interruption along the first, second, or third order neuron in the sympathetic pathway. Dr. Patel emphasizes that any patient presenting with painful Horner syndrome is considered to have a carotid dissection until proven otherwise. Since urgent neuroimaging is necessary, CT or MR angiograph are excellent for vascular pathology but require imaging from the apex of the lung to cervical villus and must include the neck. If the patient has a soft tissue injury, MRI may be preferable; however, this is an emergency that requires partnering up with a neurologist.

Watch other 1-Minute videos by Dr. Patel:
What To Do When You Suspect Giant Cell Arteritis
Evaluating Patients with Potential Third Nerve Palsy

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