eMedicine Specialties > Oncology > Carcinomas of the Lung and Other Intrathoracic Carcinomas

Horner Syndrome: Follow-up

Author: Malvinder S Parmar, MB, MS, FRCP(C), FACP, FASN, Assistant Professor (VPT), Faculty of Medicine, University of Ottawa; Associate Professor, Department of Internal Medicine, Northern Ontario School of Medicine; Consulting Physician, Timmins and District Hospital, Ontario, Canada
Contributor Information and Disclosures

Updated: Nov 24, 2009

Follow-up

Prognosis

  • Prognosis depends on the underlying cause of the syndrome.

Miscellaneous

Medicolegal Pitfalls

  • Since malignancy is a prominent feature of recently diagnosed preganglionic Horner syndrome, patients may avoid an unnecessary extensive workup for carcinoma if the physician can document that the lesion is old or long-standing. To prove that a lesion is long-standing, inspect old photographs of the patient that might show ptosis or anisocoria. If the affected iris is blue and the other iris is brown, the lesion most likely was present at birth, or at least during the first 2 years of life. This color asymmetry will of course not occur in patients who are genetically blue eyed.
  • Painful Horner syndrome should alert to the possibility of carotid artery dissection, and the patient should undergo further testing (ie, magnetic resonance imaging/angiography of the brain and neck) to exclude this possibility. Internal carotid artery dissection is life-threatening and carries the risk of the patient experiencing a disabling stroke.
  • A negative apraclonidine test result does not exclude Horner syndrome, especially in acute cases, as upregulation of alpha1-receptors takes between 5 and 8 days. A cocaine test should be performed in such cases to exclude Horner syndrome.
 


More on Horner Syndrome

Overview: Horner Syndrome
Differential Diagnoses & Workup: Horner Syndrome
Treatment & Medication: Horner Syndrome
Follow-up: Horner Syndrome
References
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References

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Further Reading

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Keywords

Bernard syndrome, Bernard-Horner syndrome, Horner syndrome, Horner's syndrome, Horner’s oculopupillary syndrome, Horner oculopupillary syndrome, Horner’s sign, Horner sign, Horner's symptom complex, Horner symptom complex, Horner's triad, Horner triad, Hutchinson’s syndrome, Hutchinson syndrome, Mitchell’s syndrome III, Mitchell syndrome, oculosympathetic paralysis, Raeder paratrigeminal syndrome, Raeder’s paratrigeminal syndrome, heterochromia irides, von Passow’s syndrome, von Passow syndrome, miosis, constricted pupil, partial ptosis, hemifacial sweat, hemifacial anhidrosis, facial sweating, facial flushing, harlequin effect  

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Contributor Information and Disclosures

Author

Malvinder S Parmar, MB, MS, FRCP(C), FACP, FASN, Assistant Professor (VPT), Faculty of Medicine, University of Ottawa; Associate Professor, Department of Internal Medicine, Northern Ontario School of Medicine; Consulting Physician, Timmins and District Hospital, Ontario, Canada
Malvinder S Parmar, MB, MS, FRCP(C), FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Nephrology, Canadian Medical Association, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Philip Schulman, MD, Chief, Medical Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center; Clinical Professor, Department of Medicine, New York University School of Medicine
Philip Schulman, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology, and Medical Society of the State of New York
Disclosure: celgene Honoraria Speaking and teaching; Amgen Honoraria Speaking and teaching; genetech/idec Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Benjamin Movsas, MD, Vice-Chairman, Department of Radiation Oncology, Fox Chase Cancer Center
Benjamin Movsas, MD is a member of the following medical societies: American College of Radiology, American Radium Society, and American Society for Therapeutic Radiology and Oncology
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting; FibroGen Consulting fee Consulting

 
 
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