0
Article |

Testing the Pupil in Horner's Syndrome

Nancy M. Newman, MD; Peter S. Levin, MD
Arch Neurol. 1987;44(5):471-471. doi:10.1001/archneur.1987.00520170003001
Text Size: A A A
Published online

To the Editor.  —In the February 1986 issue of the Archives, Stone et al1 convincingly documented a case of hypothalamic infarction caused by a Horner's syndrome that disrupted the preganglionic sympathetic pathway of the first-order neuron. They pointed out the importance of detecting a preganglionic lesion as a cause of Horner's syndrome (in contrast to the more common postganglionic lesion).To exclude postganglionic sympathetic pathway disruption, the authors used a direct-acting adrenergic agent (epinephrine hydrochloride diluted 1:1000) to test for denervation hypersensitivity of the iris sphincter muscle. This method of testing for postganglionic Horner's syndrome may result in inconclusive responses, as it is dependent on precise and equal doses reaching the iris sphincter.2 Thus it is affected by disruption of the corneal epithelial barrier3 (as may occur after testing corneal sensation and/or intraocular pressure, or from corneal exposure in patients having seventh cranial nerve palsy or decreased

REFERENCES

Stone WM, de Toledo J, Romanul FCA:  Horner's syndrome due to hypothalamic infarction: Clinical, radiologic, and pathologic correlations . Arch Neurol 1986;;43:199-200.
Thompson HS, Mensher JH:  Adrenergic mydriasis in Horner's syndrome: Hydroxyam-phetamine test for diagnosis of postganglionic defects . Am J Ophthalmol 1971;;72:472-480.
Thompson HS:  Diagnostic pupillary drug test , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1972;, vol 3, pp 76-90.
Skarf B, Czarnecki JSC:  Distinguishing postganglionic from preganglionic lesions: Studies in rabbits with surgically produced Horner's syndrome . Arch Ophthalmol 1982;;100:1319-1322.
Maloney WF, Younge BR, Moyjer NJ:  Evaluation of the causes and accuracy of pharmacologic localization in Horner's syndrome . Am J Ophthalmol 1980;;90:394-402.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Stone WM, de Toledo J, Romanul FCA:  Horner's syndrome due to hypothalamic infarction: Clinical, radiologic, and pathologic correlations . Arch Neurol 1986;;43:199-200.
Thompson HS, Mensher JH:  Adrenergic mydriasis in Horner's syndrome: Hydroxyam-phetamine test for diagnosis of postganglionic defects . Am J Ophthalmol 1971;;72:472-480.
Thompson HS:  Diagnostic pupillary drug test , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1972;, vol 3, pp 76-90.
Skarf B, Czarnecki JSC:  Distinguishing postganglionic from preganglionic lesions: Studies in rabbits with surgically produced Horner's syndrome . Arch Ophthalmol 1982;;100:1319-1322.
Maloney WF, Younge BR, Moyjer NJ:  Evaluation of the causes and accuracy of pharmacologic localization in Horner's syndrome . Am J Ophthalmol 1980;;90:394-402.

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.