Horner's Syndrome: Free MSRA Podcast Podcast Por arte de portada

Horner's Syndrome: Free MSRA Podcast

Horner's Syndrome: Free MSRA Podcast

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 🎧MSRA Podcast:Horner’s Syndrome — Spot the Subtle, Catch the SeriousWelcome to the DeepDive. Today we’re breaking down Horner’ssyndrome, a subtle but highlysignificant neurological sign that could point to dangerous underlyingpathology — including carotid dissectionsand Pancoast tumours. Whether you'rerevising for the MSRA or brushing up your clinical eye, this one's essential. 🧠What Is Horner’sSyndrome?Horner’s syndrome isa neurological condition caused by disruption of sympathetic innervation to theeye and face. It results in the classic triad:• Ptosis (drooping eyelid)• Miosis (constricted pupil)• Anhidrosis (lack of sweating on the same side)Also look for apparent enophthalmos (sunken eye) and heterochromia in congenital cases. 🧬Neuroanatomy MadeEasy — The 3-Neuron Pathway:Think of it as arelay race:1️⃣First-order neuron: Hypothalamus → spinal cord (C8–T2)2️⃣Second-order neuron: Leaves spinal cord → sympathetic chain → superior cervical ganglion3️⃣Third-order neuron: Travels with internal carotid artery → cavernous sinus → eye muscles and sweat glandsA lesion anywhere along this route causesHorner’s — and location helps determine the cause. 🔍Causes Categorised byLesion Level:Central (First-order):• Brainstem strokes• MS• Tumours• Syringomyelia• ChiarimalformationPreganglionic (Second-order):• Pancoast tumour (apical lung cancer)• Chest/neck trauma• Carotid dissection• Neuroblastoma inchildren• Cervical rib orenlarged lymph nodesPostganglionic (Third-order):• Cluster headaches• Migraine• Cavernous sinuspathology• Herpes zoster• Carotid arteryaneurysms 🧪Diagnosis &Testing:Clinical examinationis key, especially comparing anisocoria in dimlight.✅Pharmacologicalconfirmation:• Cocaine drops – fail to dilate Horner’s pupil• Apraclonidine – reverses anisocoria by dilatingHorner’s pupil• Hydroxyamphetamine – distinguishes pre- vspost-ganglionic lesionsPupil dilates → preganglionicNo dilation → postganglionic💡Mnemonic:"C-A-H"• Cocaine confirms• Apraclonidine confirms + reverses• Hydroxyamphetamine localises 🔬Investigations Basedon Suspicion:• MRI/CT head & neck• Chest x-ray or CT thorax for apical lung tumour• CT angiogram or carotidDoppler for suspected dissection• Full neuro +systemic exam to identify associated pathology 💊Management:• No treatment for Horner’s directly• Target the cause:Tumour resectionStroke managementVascular repair (e.g., carotid dissection)Referral to neuro/ophthalmology where appropriate 📈Prognosis &Complications:• Prognosis dependson underlying cause• Horner’s signs mayresolve, persist,or progress• Key danger: missing a life-threatening cause like carotid dissection or lung cancer 🧠MSRA Key LearningPoints:• Triad = Ptosis, Miosis, Anhidrosis• Understand the 3-neuron sympathetic pathway• Think Pancoast tumour in smokers, dissection in neck pain• Use pharmacological testing to confirm &localise• Management alwaystargets the primary lesion• Early imaging is vital 📚Horner’s SyndromeMSRA Resources:📝 Revision Notes:https://www.passthemsra.com/topic/horners-syndrome-revision-notes-2/🃏 Flashcards:https://www.passthemsra.com/topic/horners-syndrome-flashcards/📖 Accordion Q&A Notes:https://www.passthemsra.com/topic/horners-syndrome-accordion-qa-notes/🧠 Rapid Quiz:https://www.passthemsra.com/topic/horners-syndrome-rapid-quiz/🎯 Quiz Link:https://www.passthemsra.com/quizzes/horners-syndrome-2/ 🌐More MSRA Tools &Resources:https://www.passthemsra.comhttps://www.freemsra.com#MSRA#HornersSyndrome #MSRAFlashcards #MSRARevisionNotes #MSRAQuiz #Neurology#Ophthalmology #CarotidDissection #PancoastTumour #Ptosis #Anisocoria#PassTheMSRA #FreeMSRA #GPTraining
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