What conditions should be considered in the differential diagnoses 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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Conditions to be considered in the differential diagnoses include the following:

  • Adie pupil
  • Physiologic anisocoria and involutional ptosis
  • Argyll Robertson pupil
  • Holmes-Adie pupil (contralateral)
  • Iris sphincter muscle damage
  • Senile miosis
  • Third nerve palsy

Unilateral use of miotic drugs or mydriatic drugs should also be considered in the differential diagnoses. Other medications to consider include local anesthetics (lidocaine, bupivacaine, etidocaine), acetophenazine, alseroxylon, butaperazine, carphenazine, chloroprocaine, chlorpromazine, deserpidine, diacetylmorphine, diethazine, ethopropazine, fluphenazine, guanethidine, influenza virus vaccine, levodopa, lidocaine, mesoridazine, methdilazine, methotrimeprazine, oral contraceptives, perazine, prilocaine, procaine, prochlorperazine, promazine, promethazine, propoxycaine, reserpine, thioproperazine, thioridazine, and trifluoperazine.

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