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Results for “HORNER SYNDROME”

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PubMed1998

[Claude Bernard-Horner syndrome and its opposite, Pourfour du Petit syndrome, in anesthesia and intensive care].

OBJECTIVE: To analyse cases of Horner's syndrome (HS) and its opposite, Pourfour du Petit's syndrome (PPS), occurring in anaesthesia and intensive therapy with consideration of the data of current literature. DATA SOURCES: For this paper we have reviewed the French, English and German literature published in anaesthesia and intensive care journals using Medline search and the current textbooks. STUDY SELECTION: All observational studies on these syndromes, whether clinical cases or letters to the editor, form the basis for this article. DATA EXTRACTION: The articles were analysed mainly with regard to diagnosis, therapy and prognosis of syndromes due to iatrogenic causes. DATA SYNTHESIS: HS is caused by a paralysis of the ipsilateral sympathetic cervical chain and includes a ptosis of the upper eyelid, a slight elevation of the lower lid, a sinking of the eyeball, a constriction of the pupil, a narowing of the palpebral fissure, a nasal stuffiness associated with anhidrosis, and flushing of the affected side of the face. Regional anaesthesia (intra-oral anaesthesia, brachial plexus block, epidural anaesthesia whether by thoracic, lumbar or caudal approach, as well as interpleural analgesia) is the main anaesthetic cause for HS. HS due to the effect of a local anaesthetic is transient, it can precede a high spinal block and a cardiovascular collapse. HS from puncture of the internal jugular vein is most often permanent. When transient, HS regresses within 3 months after puncture. Other causes of HS include intraoperative posture, pleural drain, neck surgery, neck trauma. A mydriatic collyrium, such as phenylephrine, resolves ptosis for less than 1 hour and results in blurred vision from pupillary dilation. Major ptosis requires surgery. PPS is the reciprocal HS and is caused by a stimulation of the ipsilateral sympathetic cervical chain. PPS can precede HS. It carries a risk for conjunctivitis, keratitis and epiphora in case of major exophthalmia. PPS is often reported as an unilateral mydriasis. PPS has the same causes as HS. Myotic collyriums are relatively inefficient. Major lid retraction requires a tarsorraphy, pomades and nocturnal lid occlusion. A part of HS and most PPS occurring in anaesthesia and intensive care remain unrecognized or are recognized with delay, especially if they remain minor and transient or when they occur in unconscious patients, in horizontal posture.

Adolescent↗
PubMed1982

[Report of 2 cases of irreversible Horner syndrome after puncture of the internal jugular vein].

Two cases are presented with irreversible Horner's syndrome after cannulation of the internal jugular vein during the intraoperative period. In the first case the cannulation succeeded only after several attempts. In the second case the cannulation succeeded the first time. All cannulations were performed by experienced anaesthesiologists. This means, that a strict indication for the cannulation of the internal jugular vein must be considered, because of the possibility of irreversible damage, even if the cannulation is performed by an experienced physician.

Adult↗
PubMed1977

[Horners syndrome. A complication of the lateral recumbent position (author's transl)].

The appearance of a unilateral Horner's syndrome after an anesthetic in the lateral recumbent position is reported. It was caused by a damage to the sympathetic nerve at the level of Th 1 probably due to the extreme lateral flexion of the cervical vertebral spine. The importance of correct positioning of the head during anesthesia is stressed.

Adult↗
PubMed1986

[Recurrent nerve paralysis and Claude Bernard-Horner syndrome following an interscalene block of the brachial plexus].

The association of a recurrent laryngeal block with a Horner's syndrome occurred in one patient after right interscalene brachial plexus block. Hoarseness was the main clinical symptom of recurrent paralysis and lasted 4 h. The subsequent course was totally uneventful and required no specific treatment. But the interscalene route of brachial plexus block may be potentially hazardous in the patient with a full stomach.

Adult↗