Horner Syndrome - anatomy, causes, pathophysiology, investigation

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"Horners syndrome is a classic neurologic syndrome with three distinct clinic signs on one side of the face: ptosis (dropping of eyelid), miosis (constriction of pupil) and anhydrosis (no sweating).
Horner syndrome can result from a lesion anywhere along a three-neuron sympathetic (adrenergic) pathway that originates in the hypothalamus.
The aetiology of Horner syndrome in adults relates to the lesion location. 40 percent of cases of Horner syndrome the diagnosis is unknown. Majority is caused by lesions in the second or third order neurons."
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[@maissenetag2041]

I’m at my fifth year of medical studies and we’ve always seen this syndrome in different modules but I’ve never understood it that well, thank you very much !!

[@azrieldia7638]

I had a hard time following this topic during our lecture but you made it easy with incredible illustrations! Thank you so much!

[@MedNerdDrWaqasFazal]

You are an inspiration for me. I wish one day people will find my videos as helpful as yours.

[@wikimedmedicine]

great job man

[@benettryan4048]

i just saw your video its really amazing.Subscribed.looking forward to more of these flowcharts.

[@veenavisulakkhana9968]

00:00:00 Horner's syndrome is described as a classic neurologic syndrome characterized by three distinct clinical signs on one side of the face: ptosis (drooping of the eyelid), meiosis (constriction of the pupil), and anhydrosis (no sweating) on the affected side. The syndrome is caused by a lesion anywhere along the sympathetic pathway that supplies the head, neck, and eye, which includes three neurons that arise from the hypothalamus, descend through the cervical spinal cord, and ascend through the superior cervical ganglion and internal carotid artery to innervate the iris dilator muscle, Muller's muscle, and sweat glands. 00:05:00 the causes of Horner syndrome are discussed, which is a condition characterized by the loss of sympathetic nerve function. The causes are classified into three categories: lesions in the first-order neuron, second-order neuron, and third-order neuron. Lesions in the first-order neuron can be caused by hypothalamic strokes or tumors, brain stem strokes, brain stem tumors, and spinal cord lesions. Lesions in the second-order neuron can be caused by apical lung lesions, pancreatic tumors, subclavian artery aneurysms, and mediastinal masses. Lesions in the third-order neuron can be caused by cavernous sinus issues, internal carotid artery aneurysms, and pituitary tumors. 00:10:00 the diagnostic process for Horner's syndrome, highlighting the importance of the "drop test" in localizing the lesion and distinguishing between third-order neuron and first- or second-order neuron lesions. Additionally, imaging tests such as MRI brain, neck, or CT angiogram are necessary to identify potential underlying causes, including tumors, carotid artery dissections, or lesions along the sympathetic pathway.

[@frogprincessss]

great video. You explained it better than any of my professors ever did.

[@coolocean1307]

Fantastic explanation deserve my salute

[@ankitmayank9478]

most beautiful explanation on youtube for horner

[@amiramohamedabdelazeem6165]

amazing..but where are the colourful pens? I miss it

[@armandohasudungan]

I know :( me too

[@KawaiiGirl0514]

One of my eyes was always uneven than the other, and eventually thought I had a lazy eye. But then I found out that I had Horner’s syndrome because I have Right brachial plexus palsy which affected my right eye, which was why my eye shape was uneven after doing research and looking it up. And I never knew this my whole life till about 4 months ago lol. Crazy how my brachial plexus is a reason my eye is more slanted and droopy than the other. I thought that was pretty interesting. And great video 👍🏽

[@claudiamarin7501]

Seems complicated, how was the diagnosis?

[@eyecandie2004]

What is the treatment?

[@Alice-tq6bl]

Thank you, this video is really well- explained, especially the clinical parts helped. I wonder if you could make an episode on II and III cranial nerve damage and it’s clinical symptoms, or eye nerves in general

[@eatymceatison97]

Hey, man. I'm so glad I found out about your channel.

[@goncalvescarlosfernando5403]

Thanks a lot for the explanation .

[@Lafloofen]

I have this after spine surgery No one has ever seen this happen. I’m devastated

[@nik8423]

Very well and throughly explained in short time ❤

[@PiyaChoudhari]

This is a beautiful video but one point is missed here which would make this video super complete and perfect and that congenital horner's syndrome

[@nu7493]

Great video - as usual! I do have a question: At 6:50, you say the 3rd order neurons that supply facial sweat glands travel with the External carotid, then later state that 3rd order neurons travel in the Internal carotid adventitia. Do you mean JUST nerve supply of the sweat glands...or the entire 3rd order neurons? that travel with the ECA . I hope my question is clear and Thanks again for this Video

[@k.ta2004]

I WILL BECOME A GOOD DOCTOR INSHA'ALLAH.

[@pepper658]

inshallah, me too 🥹

[@Roufeidakb]

Inshalah me too! 🙏

[@drumeshdash]

@@Roufeidakb😊

[@drumeshdash]

@@RoufeidakbQ

[@dailydoseofmedicinee]

Good summary👍

[@brianfoley4328]

Great explanation of a complex syndrome...Thank You

[@syedmunirulwadood6871]

Very nicely presented. Much appreciated.

[@fatblokes_ferguson]

I recently had a ADCF operation on C4/C5 and C5/C6. After many tests because of all of the symptoms as described in this video, the surgeon said while my spine was exposed with the help with retractors they believe it restricted blood flow because of the time the tool compressed the nerves and arteries. I have not heard of this problem before and I was first diagnosed with having a stroke, this was a very hard thing to comprehend but after many tests it was confirmed as Horner syndrome. Finding information on doctor Google it can revert back to normal but not in every case. I will have to wait and hope I return back to my pre- op state.

[@daughteroflight8624]

Excellent presentation Thanks

[@MedNerdDrWaqasFazal]

Thank you. Have been waiting for this. ❤️

[@tanishkagupta0810]

Just amazingg!! Hats off!

[@pandukaranaweera8954]

Thank u..Happy new year💐

[@jessejaybaula4231]

Thank you so much, this is amazing

[@alysfreeman11]

Nerve block for right shoulder surgery, droopy eyelid and burst blood bruise on left of my nose between eye and high area of nose, why?

[@hammerradiology1470]

I still remember the lecture I was taught about this syndrome more than 10 years ago. Sadly my professor passed of COVID this year. Thank you for sharing your knowledge.

[@sage9710]

thank you!

[@virginiatoma9110]

Well explained... thank u 🙏

[@BH-lp1vk]

I’m trying to figure out why my dog has Horner Syndrome. The ophthalmologist we saw found a foxtail in my dog’s ear. I’m hoping the constricted pupil goes back to normal now.

[@docharry999]

thanks sir

[@jisnudeepmandal]

I really miss the colourful pens

[@kyndalgarrett3175]

I just found out my daughter has this. I’m so nervous cuz she has weak muscles. 9 months old and can’t sit on her own yet.

[@abdallahnasser6358]

Armando ...ur videos r spectacular, so can I ask u to do video on the anatomy of the cartilage 🥺

[@adnanhajjar1856]

thanks

[@TheUlumpa]

Thank you man ❤

[@tridentOP9964]

Nice explaination on horner syndrome ☺️ But I think order of neurons is reversed 👀

[@vigneshram3759]

It isn't... Even I tot its reversed ... But order of neurons is not like our spinal nerves.... 1st here starts from hypothalamus

[@medhealth4495]

well explained everything

[@sarahbytheway4057]

I've had this ever since my tumor was taken out visine or any redness eyedrops in the effected eye helps even it out.i also don't sweat out of my hand it makes it look very dry and cracked and even gets a certain smell from not being able to sweat and the the other side sweats even more to make up for it.

[@blackholesable]

HELLO , what is the app name you use to make these wonderful videos

[@qayssyounis4177]

Always great

[@Hinakhan-wj6hz]

Amazing

[@urbanyolk]

Interesting topic. I would interested to see how you approach syringomyelia. I have idiopathic SM with cervical, thoracic and lumbar syrinxes. It has been a wild ride.

[@raven9802]

I have syringomyelia with a syrinx at C6-C7. I have had it since a severe neck injury in 1991 when I was 31.

[@urbanyolk]

@@raven9802 wow! I was born in 1990 and symptomatic since 1995. Thank you for sharing!

[@raven9802]

@@urbanyolk That was a quick reply. Oh you got it at a young age then. I am in England but I used to go on a site called ASAP in America. We used to chat between other who have it.

[@raven9802]

@@urbanyolk I just came across this video for horner's syndrome after searching for anhidrosis - the inability to sweat. I've been listening to the Prince Andrew story where he says he could not sweat and no one believes it, but it is a real condition. In the 1990's I was just the opposite. My syringomyelia symptoms made sweat pour out of me.

[@urbanyolk]

@@raven9802 I was also searching for that. I struggle to sweat and when I do it is just a few patches. I'm located in South Africa at the moment and will move to Italy toward the end of the year. Hopefully to try and finally find the cause.

[@N3wbMa5t3r]

I get very horner sometimes... Could I possibly have Horner's disease?

[@nu7493]

Dude... No!

[@N3wbMa5t3r]

@@leeannwarren8456 Re-read my comment slowly.

[@TopGuntrim2394]

...*slow clap*....*now rising to my feet*...

[@jessbowen7612]

I have this

[@brunofabrizio1677]

Parabéns

[@nehatawari8226]

Great 😳🙌

[@wassmmd8521]

Wow.

[@NERVESMEDICINE616]

👍

[@ethicsethics3713]

Hiii hope you are well. Im hoping to study pharmaceitical sciences masters at aston I have a question If my chemistry is weak like iv forgotten a lot of it will i struggle on the course im planning to refresh chemistry A level before startng the course

[@krraaj806]

🙏

[@linamag4830]

👍👍👍👍

[@peaceibe8056]

Very well explained! Great job.