What are the symptoms of Horner syndrome?

Updated: May 01, 2019
  • Author: Christopher M Bardorf, MD, MS; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Obtaining a careful history is very helpful in the localization of lesions causing Horner syndrome. The symptoms reported by the patient will depend on the underlying cause, as follows:

  • First-order neuron lesions – Hemisensory loss, dysarthria, dysphagia, ataxia, vertigo, and nystagmus

  • Second-order neuron lesions – Prior trauma; facial, neck, axillary, shoulder or arm pain; cough; hemoptysis; previous thoracic or neck surgery; previous chest tube or central venous catheter placement; or neck swelling

  • Third-order neuron lesions – Diplopia from sixth nerve palsy, numbness in the distribution of the first or second division of the trigeminal nerve (cranial nerve [CN] V), and pain

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