Pediatric Cervical Sympathetic Palsy Syndrome

Introduction to Cervical Sympathetic Paralysis Syndrome in Children Cervical sympathetic paralysis syndrome is also known as Horner syndrome (Hornerssyndrome), Bernard-Horner syndrome, Claude-Bernard-Horner syndrome, cervical sympathetic nerve spasm syndrome, cervical sympathetic nervous system paralysis. It is characterized by a slight depression of the diseased eye and a reduction of the pupil, but the light response is normal, the ptosis is drooping, and the same side is less sweaty. basic knowledge The proportion of the disease: the disease is rare, the incidence rate is about 0.0001% - 0.0002% Susceptible people: children Mode of infection: non-infectious Complications: cataract

Causes of cervical sympathetic paralysis syndrome in children

(1) Causes of the disease

Any cause of sympathetic nerve damage in the neck and brain stem, such as trauma, surgery, tumor, inflammation, vascular disease and other factors, can cause this disease, lower hypothalamus, brain stem, cervical spinal cord, carotid artery inflammation Tumor compression, bleeding and other factors can also be caused, a small number of cases can be congenital or no obvious cause can be investigated.

(two) pathogenesis

Stimulation of the sympathetic nerve can produce pupil dilation, widening of the cleft palate, prominent eyeballs, vasoconstriction, and symptoms of hyperhidrosis in the head and face. Therefore, when the sympathetic nerve center to the eye and face pathways, the opposite effect occurs in any part of the above causes.

Prevention of cervical sympathetic paralysis syndrome in children

At present, there are no systematic preventive measures, trauma, surgery, tumor, inflammation, blood vessels and other diseases can cause this disease, should pay attention to prevent the occurrence of intrinsic.

Complications of cervical sympathetic paralysis syndrome in children Complications cataract

There is excessive tearing or tearing, and occasionally cataracts.

Symptoms of Cervical Sympathetic Paralysis Syndrome in Children Common Symptoms of drooping eyelids, paralysis, tears, invagination, pupils, asymmetrical facial side, sweating, another...

Found on the same side of sympathetic damage,

1. Pupil narrowing: Due to the pupil of the iris opening the muscle paralysis, but the light response, the convergence reaction exists.

2. Eyelid drooping: caused by palpebral muscle paralysis, due to drooping eyelids, eye cracks are slightly smaller, but the eyelids can still open and close by themselves.

3. Eyeball invagination: related to the palpebral muscle paralysis behind the eyeball.

4. Less sweat on the same side: Department of glandular secretion dysfunction, see dry face, no sweat, fever, flushing performance.

5. Decreased intraocular pressure: related to the influence of vascular neuromodulation. If the symptom is congenital or occurs in children, it is often accompanied by iris discoloration. Others have excessive tearing or tearing, and transient low intraocular pressure, occasionally Cataract, the early expansion of the eyelids, conjunctiva, uveal and retinal blood vessels temporarily expanded.

Examination of cervical sympathetic paralysis syndrome in children

If there is inflammation, there may be an increase in white blood cells and neutrophils; if there is a bleeding disorder, there may be clotting time, coagulation factors, abnormalities of prothrombin, and the like.

Combined with clinical electrocardiogram, B-ultrasound, CT, MRI and other examinations.

Diagnosis and diagnosis of cervical sympathetic paralysis syndrome in children

diagnosis

Combined with medical history and clinical manifestations, the diagnosis is generally not difficult. 4% cocaine eye drops can be used, 3 minutes once, for a total of 3 times, and pupils are observed after 15 minutes.

Differential diagnosis

1. Identification of sympathetic neuron damage: sympathetic neuron damage can be enlarged at the central stage, and there is no reversal of sympathetic neurons after anterior ganglia; after observation with 0.1% adrenaline droplets for 45 minutes, sympathetic ganglion fibers In the case of damage, the pupil is enlarged, and there is no change in the central part and the pre-section.

2. Incomplete type of differential diagnosis: This syndrome is more common in clinical, but more common is incomplete type, especially eye sag is often not obvious, mild ptosis is easy to neglect, non-ophthalmologists have diagnosis The pupil of the value is reduced, and if it is not carefully examined, it is more likely to be missed. Therefore, when the syndrome is suspected, special attention should be paid to the binocular contrast test.

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