Open AccessPositive Apraclonidine Test 36 Hours After Acute Onset of Horner Syndrome in Dorsolateral Pontomedullary Stroke
Author(s) -
Maud Lebas,
J Séror,
Thomas Debroucker
Publication year - 2010
Publication title -
journal of neuro-ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.586
H-Index - 55
eISSN - 1536-5166
pISSN - 1070-8022
DOI - 10.1097/wno.0b013e3181b1b41f
Subject(s) - anisocoria , horner syndrome , medicine , lesion , stroke (engine) , brainstem , anesthesia , surgery , psychology , pupil , neuroscience , mechanical engineering , engineering
A 40-year-old man developed a Horner syndrome as part of a dorsolateral medullary brainstem infarction. Thirty-six hours after the onset of the stroke, topical instillation of 0.5% apraclonidine produced reversal of anisocoria. This is the first case in which apraclonidine testing has been applied to a patient with a Horner syndrome caused by a lesion in the first segment of the oculosympathetic pathway and the shortest reported interval between clinical manifestations of the lesion and apraclonidine-induced reversal of anisocoria. A review of all reported cases of apraclonidine testing in Horner syndrome suggests that this is a promising diagnostic adjunct that must be validated in larger studies.