Abstract
PURPOSE: To alert ophthalmologists to the possibility of a spinal cord lesion in individuals with Horner syndrome and no neurologic symptoms. DESIGN: Observational case report. METHODS: Neuro-ophthalmic and neuroimaging assessment of a 16-year-old man with an isolated Horner syndrome localizing to a first- or second-order neuron. RESULTS: With magnetic resonance imaging, a syrinx of the cervical spinal cord extending from C5 to C7 was found. No Chiari malformation was present. CONCLUSION: Patients with an isolated Horner syndrome localizing to a first- or second-order sympathetic neuron should undergo magnetic resonance imaging of the head, neck, spinal cord, and chest to investigate for possible origins. An isolated Horner syndrome may be the presenting manifestation of a cervical syrinx.
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