Horner's Syndrome

An attentive person can sometimes notice passers-by or a neighbor living next to him, not quite in proportion to the structure of his face or something wrong with his eyes. It is possible that such a person is progressing a disease that has the name Horner's syndrome in medicine. The basis for the development of this disease is pathological changes affecting the autonomic nervous system of a person.

[1], [2], [3], [4], [5], [6], [7]

Causes of the horner's Syndrome

This disease was first painted by Johann Horner, from where it got its present name. The main causes of Horner's syndrome lie in the plane of symptomatic ways of development of some diseases.

To such it is possible to carry:

• Neurofibromatosis of the first type.
• Neoplasm in Pancostia.
• Congenital changes affecting the bundle of nerve endings.
• Neuralgia of the trigeminal nerve.
• Multiple sclerosis.
• Consequence of injury.
• Myasthenia gravis is a mutation of a gene responsible for the work of neuromuscular synapses.
• Neoplasm, localized in the hypothalamus, spinal cord and brain.
• Occlusion of veins of the cavernous sinus.
• Inflammation affecting the costal part of the skeleton and / or the upper parts of the spine.
• Migraine pain.
• Frequent alcohol and other kinds of poisoning (intoxication) can also lead to the progression of typical signs of Horner's syndrome.
• The consequence of a stroke is a cerebral hemorrhage.
• Syringomyelia is a chronic progressive pathology of the nervous system, as a result of which cavities are formed in the body of the spinal cord.
• Otitis is an inflammatory process localized in the middle ear.
• Aneurysm of the aorta.
• Growth of thyroid parameters as a result of goiter. Simatectomy.

Symptoms of the horner's Syndrome

Doctors say a few signs that may indicate the presence of a given pathology in humans. It should be noted that they can be observed not all together - in a complex, but only some of them. But there should be at least two such signs at the same time, in order to be able to make an assumption about the presence of the disease.

The main, most common, symptoms of Horner's syndrome are:

• Myos - the pupil of the affected eye is narrowed.
• Ptosis of the eyelids is a decrease in the lump of the eye between the upper and lower eyelids.
• Omission of the upper, less frequent increase in the lower eyelid.
• Reduced response of the pupil to external stimuli, and specifically - to a beam of light.
• In the case of a congenital type of disease in small patients, iris can be heterochromic. That is, the uneven distribution of the color color of the iridescent part of the eye, its different coloring.
• There may be a reduced amount of sweat (facial localization from the side of ptosis), and the amount of tear substance decreases.
• Half of the face on the affected side is hyperemic. The appearance of the so-called Purfur du Petit syndrome is also possible - a set of eye symptoms obtained in connection with an irritating effect on the sympathetic nerve: mydriasis, exophthalmos, a wide eye gap, an increase in intraocular pressure, an expansion of the vessels of the choroid and the retina.

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Forms

[9], [10]

Congenital Horner Syndrome

To date, doctors have noted a significant increase in the number of diagnosed pathologies that were obtained by a person during the period of intrauterine development. Nor is the innate Horner syndrome. The most common cause provoking its development may be a trauma that the fetus received in the process of delivery.

With this form of the disease, ophthalmologists often observe the effect in which the iris of the newborn's eye, and later on the more adult patient, does not acquire pigmentation, remaining a greyish-blue hue. Reduced and the reaction of the eye to the introduction of special dilating drops, which may indicate the presence of a newborn congenital syndrome Horner.

[11], [12], [13], [14]

Incomplete Horner Syndrome

But this disease may not have a pronounced symptomatology, which an amateur can also notice. The considered disease in this case can be recognized only by a certified specialist - at a reception with an ophthalmologist who will diagnose incomplete Horner's syndrome.

The symptomatology of this type of disease is fully determined by the level of changes and the scale of the defeat of sympathetic structures.

Horner's syndrome in children

How sad it sounds, but besides the congenital pathology, which was already mentioned above, Horner's syndrome in a child can manifest itself at a later stage of development.

At the same time, doctors note that if the disease begins to show itself before the age of two years, it is possible development of a pathology such as iris heterochromism, in which there is a decreased pigmentation (or complete absence of it) on the eye from the affected side of the face. The reason for this underdevelopment is explained by the lack of sympathetic innervation, which does not allow the production of melanocytes, which lead to the coloring of the iris of the eye in a certain color.

Paralysis of visual sympathetic fibers can have congenital roots, but it can only be recognized after more than one year. But the reason for the development of the disease in question may well be the surgical intervention carried out on the baby's chest. For example, when correcting congenital heart disease. To get Horner's syndrome a child is possible in the presence of other pathological changes in his growing body, or because of external factors that have already been mentioned in the causes of the pathology in question.

In some cases, doctors had to observe a paradoxical sharp decrease in the pupillary zone against a background of suddenly darkness (light turned off in the room), after which the pupil slowly increases its size. In this case, the response to external stimulation by a beam of direct light is close to normal. To date, the essence of this phenomenon physicians to the end is not understood. As an option - an anomaly in the development of the retina or optic nerve.

Diagnostics of the horner's Syndrome

There may be suspicions about the presence of the disease both in the person himself or her parents, if it concerns the child, and the pediatrician or ophthalmologist at the next appointment. The doctor raises the question of a specialized examination of the patient's body, if there are at least two symptoms, from the signs listed above.

Diagnosis of Horner's syndrome includes a number of activities, which include:

• Testing of the affected pupil with special eye drops based on cocaine. After instillation of a healthy organ, its expansion is observed. This reaction is caused by blocking the back clamp of norepinephrine. In the case of the presence of the considered disease in the synaptic crack, norepinephrine deficiency is observed, which does not lead to the expected reaction, inhibiting the process.
• In the absence of pupil dilatation, after 48 hours after the first test, the treating doctor is assigned additional studies. This diagnostic step allows you to identify the level of damage. A solution of hydroxyamphetamine (1%) drips into the pupil, and a 5% solution of p-methylhydroxyamphetamine can be substituted for it. Based on the results of the reaction, and the diagnosis is made: if the reaction to the expansion is present, then a preganglionic type lesion is detected, but if such a pupil response is not observed, postganglionic type of Horner's syndrome is diagnosed.
• The patient will also have to undergo magnetic resonance imaging or computed tomography of the brain and spinal cord, the upper spine. The doctor's choice of a particular study directly depends on the expected scale and depth of pathological changes.
• It may be necessary to conduct an X-ray study, which will make it possible to detect a developing tumor and to determine its localization.

Treatment of the horner's Syndrome

Only after establishing the correct diagnosis, a qualified specialist is able to write down those medical measures that, if not lead to complete cure, then, at least, will significantly improve the health situation of the patient.

The main thrust that the Gorner syndrome must withstand is the activation of the load of nerve endings and the muscle tissue of the affected eye. To this end, the patient is assigned kinesiotherapy, in parallel with which the myoi neurostimulation is carried out.

The essence of the last method of influencing the changed organ is reduced to an irritating effect of impulse current on pathological tissues. In this case, the nivats extend to absolutely all structures that can be perceived.

The myoi technique of neurostimulation makes it possible to develop and adapt to further loads even those muscles in which there is great weakness with a sufficiently high degree of efficiency. Such stimulation is performed with the use of cutaneous electrodes, through which the charge is fed. This procedure is quite painful and is conducted under the direct supervision of a qualified medical professional. But as a result, the patient is able to appreciate the obvious improvements in the state of the affected eye.

After the procedure, the following is observed:

• Activation of outflow of lymphatic fluid from the diseased site.
• Improve blood flow.
• Stimulation and normalization of all metabolic processes.
• Increased muscle tone.

It should be noted immediately that after receiving this result, do not stop at what has been achieved. After this complex treatment a person should continue independent studies, designed to keep these muscles in a normal working condition. For this purpose, specialists developed a special complex called kinesiotherapy. In its composition there are breathing exercises, medical gymnastics, loads using simulators, versatile sports and applied competitions and outdoor games.

But if all efforts do not lead to a positive result, the attending doctor can come to a decision about the appointment of an operative intervention. This is possible in case of excessive ptosis. The facial plastic surgery allows to relieve the patient of this defect, provoked by the considered illness. The plastic surgeon is able to completely restore the lost configuration of the eye gap, returning the patient a healthy appearance.

Treatment of Horner's syndrome by alternative means

It should be noted immediately that, due to the lack of a deep understanding of the mechanism of development of the pathology in question, it is not necessary to engage in independent treatment at home. Treatment of Horner's syndrome by alternative means can be carried out only as maintenance therapy and with the consent of the treating doctor.

One of the simplest methods of therapy is the use of lifting creams, which are able for a certain time to reduce the symptomatic manifestation of ptosis of the century. But even in this case, you should not assign it yourself. Especially this issue is relevant for patients who are prone to the manifestation of allergic reactions. In this case, you need to stop your choice on hypoallergenic cream formulations.

In the treatment of Horner's syndrome by alternative means, it is possible to use aromatic oils and masks showing a tightening effect. Suitable and massages, but they must be performed by a specially trained specialist, or the patient should undergo an express course.

This article contains only some masks that can be used to improve the cosmetic characteristics of the problem area.

• One of these compounds can be called a sesame-egg mask, which is obtained after mixing a thoroughly beaten yolk of one egg with a few drops (enough steam) of sesame oil. The resulting composition is applied evenly to the injured veto and left so for twenty minutes, then gently washed off with warm water.
• A good result is shown by another mask: a tuber of potatoes is washed and grinded on a grater. After this, the resulting slurry for a quarter of an hour is placed in a cool place (refrigerator will do). Next, the potato cake is distributed neatly in a sore spot and allowed to "work" for twenty minutes. At this time, it is advisable for the patient to lie down. After the time has elapsed, rinse with warm water, the excess of which should be gently dabbed with a tissue.

Regular application of these masks will not only lead to a better situation for the disease, but also help to get rid of the small wrinkles that border the eye.

• Effective themselves and recommended massages. Before the procedure, it is necessary to degrease and remove the scarred scales from the skin of the eyelid. Massaging movements should be carried out very carefully, with the help of a cotton swab, on which a medicinal composition with antiseptic characteristics was previously applied. It can be 1% tetracycline ointment, 1% solutions of sodium sulfacyl or synthomycin. It is possible to use other medications. Modern pharmacies offer the consumer a wide range of such drugs. The main thing is that they are appointed by the attending physician. Movements should be easy, stroking, with a slight pressure, start at the inner corner and end in the outer area. Such procedures should be performed daily for 10-15 days. Movements should alternate: from circular to rectilinear, with a slight pat.

Specialists have also developed exercises to increase the tone of the eye muscles. Exercises are held standing. All gymnastics is done with eyes, without lifting or turning heads. Each exercise is repeated six to eight times.

• With one eye, we try to look as high as possible, then drop it abruptly and try to look under our feet.
• We try not to turn our heads to look first at the left, and then at the right.
• We strain our eyes, looking up and to the left, after which we look diagonally down to the right.
• We strain our eyes, looking up and to the right, after which we move our eyes diagonally down to the left.
• The next exercise begins with the fact that one hand is stretched out in front of you and fix your eyes on the index finger. Without stopping from it, slowly we bring the phalanx to the tip of the nose. The image can be doubled.
• The phalanx of the index finger should be placed on the bridge of the nose and alternately look at it with the right or the left pupil.
• We make circular motions with our eyes first into one, then to the other side.
• We count to ourselves, trying to withstand up to 15 seconds, while blinking intensively with our eyes. Take a short break and repeat the approach. And so four times.
• Fix a look at a very close subject, then translate it as far as possible and fix it on the far. Again we return to the neighbor. And so several times.
• For five seconds, first close your eyes strongly, then open them sharply (stand for five seconds and then close again). Do ten such approaches.
• With your eyes closed, begin to massage your eyelids with circular pads. The procedure should be continued for a full minute.

Amplitude movement of the eyes should be as large as possible, but pain symptoms should not be allowed. The general course of stimulating eye muscle exercises should be performed daily (it can be two to three times a day) for at least three months.

Prevention

How regrettable it sounds, but absolutely effective methods that can prevent the emergence and development of the disease in question, today does not exist. However, the prevention of Horner's syndrome may consist in the fact that even with the slightest discomfort in the eye area or suspected developmental pathology, it is necessary to immediately seek advice from an ophthalmologist, be examined comprehensively and, if necessary, undergo a full course of treatment.

Only early and timely diagnosis and treatment can prevent the further development of Horner's syndrome, warning more severe forms of pathology. It is this approach to your health that increases the patient's chances of a full recovery.

[15], [16], [17]

Forecast

In itself, this disease does not belong to the category of life-threatening people, but the whole problem is that its presence can be indicative of the presence of more severe deviations. Therefore, if the suspected disease is diagnosed, the doctor will give the patient a thorough examination.

Precisely the results of the research, the early timing of treatment and the timeliness of the measures taken are in many ways the basic criteria that determine the reasonable prognosis of Horner's syndrome.

With the embryonic development of the problem and emergency adequate treatment, complete recovery is possible. But the most lasting result, of course, is plastic surgery.

As already mentioned above, Horner's syndrome does not pose a danger to the health of the affected organism. But this, in no way, does not mean that it is necessary to ignore the problem and "give up on it with a hand". Its manifestation can be the "top of the iceberg" and testify to the presence in the human body of a much more severe pathology. If we consider this disease from the point of view of aesthetics, then not everyone is ready to tolerate such disgrace on his face. Therefore, with the slightest discomfort, it is necessary to register as early as possible a consultation with an ophthalmologist who will confirm or refute suspicions and, if necessary, take effective measures. It is worth remembering that your health is in your hands!

[18], [19]