Horner's syndrome results from paralysis of the ipsilateral sympathetic cervical chain (stellate ganglion) caused by surgery, drugs (mainly high concentrations of local anesthetics), local compression (hematoma or tumor), or inadequate perioperative positioning of the patient. It occurs in 100% of the patients with an interscalene block of the brachial plexus and can also occur in patients with...

Background: Spontaneous isolated dissection of the posterior inferior cerebellar artery (PICA) is rare and presents with variable clinical course and prognosis. We report a case of spontaneous isolated PICA dissection presenting with lateral medullary infarction. Case Report: A 57-year-old female patient presented with right leg ataxia, headache, nausea and vomiting with a past medical history ...

A novel clinical study design was used to evaluate the blockade of a selective short-acting μ-opioid agonist (remifentanil) in 24 opioid-experienced subjects. Samidorphan (3-carboxamido-4-hydroxynaltrexone) is a novel opioid modulator with μ-antagonist properties. Objective (pupil diameter) and subjective (visual analog scale) responses to repeated remifentanil and saline infusion challenges we...

The effects of the prostaglandin (PG)-3 series products PGE3 and PGD3 on the intraocular pressure of rabbits were studied. PGE3 at 0.001 and 0.01 mg/eye and PGD3 at 0.01 and 0.05 mg/eye doses were applied topically (in 50-microliters volume) to the normal rabbit eye. Both PGE3 and PGD3 significantly lowered intraocular pressure at all doses tested and the IOP lowering response lasted at least 2...

Joubert syndrome (JS) is characterized by the "molar tooth sign" (MTS) with cerebellar vermis agenesis, episodic hyperpnea, abnormal eye movements, and hypotonia. Ocular and oculomotor abnormalities have been observed; however, Horner syndrome (HS) has not been documented in children with JS. We present the case of a 2-month-old boy having ocular abnormalities with bilateral nystagmus, left-dom...

Ocular inflammation and pain are a common consequence of cataract surgery, and if left untreated, may lead to extensive ocular damage, resulting in impaired vision as well as decreased satisfaction with the procedure. Effective management of ophthalmic inflammation after surgery is therefore vital. Topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) have become a mainstay of manag...

Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient pres...

A 36-year-old woman reported right eyelid drooping immediately after anterior cervical discectomy and fusion. Examination 2 weeks later revealed right miosis and right ptosis (figure, A). Instillation of one drop of 0.5% apraclonidine in both eyes resulted in reversal of anisocoria and resolution of ptosis (figure, B). Apraclonidine, a selective 2 agonist used to reduce intraocular pressure, ha...

Chest tube insertion is the most commonly performed procedure in the thoracic surgery practice. This surgical procedure has various complications, however, Horner’s syndrome resulting from compression of the stellat ganglia due to apical insertion of chest tube is extremely rare. In this article a 21-year-old male patient who was treated with chest tube insertion for spontaneous pneumothorax at...

A 60 year old male farmer presented with acute paraplegia, loss of sensations below the nipples and bowel-bladder incontinence since two days. On examination, Horner’s syndrome with ptosis, miosis and anhidrosis was noted on the left half of the face (Fig. 1). Small muscle wasting and ulnar clawing were noted in the left hand with diminished sensations suggesting a C8-T1 radiculopathy. There wa...