Horner's syndrome and Ptosis Frequently Asked Questions

What causes Horner's syndrome?
The syndrome results from the involvement of the sympathetic pathway which starts in the sympathetic nucleus and travels through the brainstem and spinal cord to the level of C8/TI/T2 to the sympathetic chain, stellate ganglion and carotid sympathetic plexus

What are the features of Horner's syndrome?
It is characterized by:

· Miosis (resulting from paralysis of the dilator of the pupil).
· Partial ptosis or pseudoptosis (due to paralysis of the upper tarsal muscle).
· Enophthalmos (due to paralysis of the muscle of Mtiller).
· Often, slight elevation of the lower lid (because of paralysis of lower tarsal muscles).

What are the causes of ptosis?
Unilateral:
· Third nerve palsy.
· Homer's syndrome.
· Myasthenia gravis.
· Congenital or idiopathic.

Bilateral:
· Myasthenia gravis.
· Dystrophia myotonica.
· Ocular myopathy or oculopharyngeal dystrophy.
· Mitochondrial dystrophy.
· Tabes dorsalis.
· Congenital.
· Bilateral Homer's syndrome (as in syringomyelia).