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Doctors' Answers to "Frequently Asked Questions" - Horners Syndrome

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Hornerís Syndrome [posted 8/11/98]
Question: I had my first child in February of 1996. During the course of labor I was given an epidural as was planned. Within a matter of minutes I started to lose feeling in the left side of my face and arm. Upon looking in the mirror I was astonished to find that I looked as though I had had a stroke. Both the doctor and the anesthesiologist told me that I was suffering from a Horner's Syndrome. Almost all of the paralysis faded within 24 hours, though my left eye occasionally is sluggish to react to light change. I am now expecting my second child and trying to find out the likelihood of suffering the same problem if I attempt to have an epidural. I would also like to know if and how this problem will effect any future medical procedures.

Answer: I don't know why you should have had a Horner's with an epidural. Consequently, I wouldn't expect a second occurrence. Did you see a neurologist? Might be useful prior to the epidural?

Hornerís Syndrome [posted 7/24/98]
Question: I had an epidural during the birth of my first child, and within minutes of it's placement I developed the visual indications of Horner's Syndrome. I am now expecting my second child and am concerned about a repeat occurrence. What is the likelihood that I will be affected in the same way if I choose to have another epidural?

Answer: This is very unusual. Did they ever figure out the mechanism? Off hand I can think of no connection, so I wouldn't expect it the second time.

Hornerís Syndrome
Question: My sister has Hornerís syndrome . She is 26 years old, and 6 months ago she had an operation for Thyroid cancer which resulted in damage to her sympathetic nerve to the eye. As cancer was transferred to lymph as well as thyroid, it seems that something happened when they removed part of lymph. We are not precisely informed why her sympathetic nerve to the eye was damaged. She has no pain in her neck or anywhere, but the right side of her eyelid droops. She has medication which stimulates the sympathetic nerve to the eye; however, there is no recovery from this symptom. Are there no treatment for these symptoms?

Answer: Horner's Syndrome is one of the potential risks of any neck surgery. It usually is irreversible, although occasionally partial damage can occur and heal over time. Sometimes up to 2-3 years. Treatment centers on keeping the eye moist since the lid is not protective as it was previously.

Horners Syndrome
Question: How is Horners syndrome detected? What is the treatment for Horner's syndrome? What is the cause?

Answer: Horners Syndrome is caused by damage or interruption of the sympathetic nerve to the eye. This causes a small, regular pupil; ptosis(drooping) of the eye lid on the same side; and occasionally loss of sweat formation on the forehead of the affected eye. The pupil will still react to light stimulus and will accommodate to distant vision. The pupil of Horners Syndrome will not enlarge in the dark. Treatment for Horners Syndrome focuses on finding the cause of the interruption of the sympathetic nerve to that area of the eye. This is usually in the neck, but can be in the brain.
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