{"id":1723470,"date":"2022-04-10T16:30:47","date_gmt":"2022-04-10T20:30:47","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=1723470"},"modified":"2023-03-16T05:35:40","modified_gmt":"2023-03-16T10:35:40","slug":"horner-syndrome-mnemonic","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/horner-syndrome-mnemonic\/","title":{"rendered":"Horner syndrome mnemonic"},"content":{"rendered":"<p>Horner\u2019s syndrome classically presents with anhidrosis, ptosis, miosis, and enophthalmos. The simple mnemonic, SAMPLE can be used to recall both the causes and clinical features of the syndrome.<\/p>\n<h2>Clinical features<\/h2>\n<p>A memory device for recalling the features of Horner syndrome is SAMPLE.<\/p>\n<ul>\n<li><strong>S<\/strong>ympathetic Nerve Paresis<\/li>\n<li><strong>A<\/strong>nhidrosis, <strong>A<\/strong>nisocoria (Difference in pupillary size)<\/li>\n<li><strong>M<\/strong>iosis (Pupillary constriction)<\/li>\n<li><strong>P<\/strong>tosis<\/li>\n<li><strong>L<\/strong>oss of the ciliospinal reflex<\/li>\n<li><strong>E<\/strong>nophthalmos<\/li>\n<\/ul>\n<h2>Etiology<\/h2>\n<p>A simple Horner syndrome mnemonic is SAMPLE.<\/p>\n<ul>\n<li><strong>S<\/strong>yringomyelia, <strong>S<\/strong>pinal trauma above the T2 spinal level, <strong>S<\/strong>pinal cord tumors and <strong>S<\/strong>troke<\/li>\n<li><strong>A<\/strong>rnold-Chiari malformation<\/li>\n<li><strong>M<\/strong>eningitis, <strong>M<\/strong>ultiple sclerosis<\/li>\n<li><strong>P<\/strong>ituitary tumors<\/li>\n<li><strong>L<\/strong>ateral medullary syndrome<\/li>\n<li><strong>E<\/strong>ncephalitis, <strong>E<\/strong>nlarged cervical masses<\/li>\n<\/ul>\n<h2>How does thyromegaly cause Horner Syndrome?<\/h2>\n<p>The <b>superior cervical ganglion<\/b> (SCG) serves as a relay center for higher-order neurons and has projecting from it,\u00a0 postganglionic neurons, which will eventually terminate in the orbit, skin of the head and neck region. The SCG lies near the thyroid and is subject to extrinsic compression in the setting of significant thyromegaly.<\/p>\n<p><a href=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-scaled.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"1cd17bd\" data-elementor-lightbox-title=\"Horner syndrome mnemonic\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-scaled.jpg\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" srcset=\"https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-scaled.jpg 2560w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-300x180.jpg 300w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-768x461.jpg 768w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-1536x922.jpg 1536w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-2048x1229.jpg 2048w, https:\/\/myendoconsult.com\/learn\/wp-content\/uploads\/horner-syndrome-mnemonic-624x374.jpg 624w\" alt=\"\" width=\"640\" height=\"384\" \/><\/a><\/p>\n<ul>\n<li>Distal innervation of <strong>Muller&#8217;s muscle<\/strong>, <strong>dilator pupillae muscle<\/strong>, and <strong>sebaceous glands<\/strong> in the skin can be impaired by clinically significant thyromegaly (due to compression of the SCG).<\/li>\n<li><strong>Motor neurons<\/strong> supplying Mullers muscle are involved, accounting for ptosis.<\/li>\n<li>The involvement of <strong>sympathetic innervation<\/strong> of the dilator pupillae muscle accounts for miosis.<\/li>\n<li>Loss of the ciliospinal relfex (pupillary dilation on compression of the neck)<\/li>\n<li><strong>Enophthalmos<\/strong> occurs because of oculosympathetic paresis.<\/li>\n<li><strong>Anhidrosis <\/strong>(an inability to sweat) occurs as a result of oculosympathetic paresis.<\/li>\n<\/ul>\n<h2>References<\/h2>\n<p>Kanagalingam S, Miller NR. Horner syndrome: clinical perspectives.\u00a0<a href=\"https:\/\/dx.doi.org\/10.2147%2FEB.S63633\" target=\"_blank\" rel=\"noopener\">Eye Brain. 2015;7:35-46. Published 2015 Apr 10.\u00a0<\/a><\/p>\n<p>Thompson HS. Johann Friedrich Horner (1831-1886). <a href=\"https:\/\/doi.org\/10.1016\/0002-9394(86)90411-3\" target=\"_blank\" rel=\"noopener\">Am J Ophthalmol. 1986 Dec 15;102(6):792-5.\u00a0<\/a><\/p>\n<h2>Images(s) Courtesy<\/h2>\n<p>MyEndoConsult<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Horner\u2019s syndrome classically presents with anhidrosis, ptosis, miosis, and enophthalmos. The simple mnemonic, SAMPLE can be used to recall both the causes and clinical features of the syndrome. Clinical features A memory device for recalling the features of Horner syndrome is SAMPLE. Sympathetic Nerve Paresis Anhidrosis, Anisocoria (Difference in pupillary size) Miosis (Pupillary constriction) Ptosis [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[107],"tags":[],"class_list":["post-1723470","post","type-post","status-publish","format-standard","hentry","category-mnemonics","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1723470","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=1723470"}],"version-history":[{"count":40,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1723470\/revisions"}],"predecessor-version":[{"id":4415829,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/1723470\/revisions\/4415829"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=1723470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=1723470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=1723470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}