Horner's syndrome is caused by: March 2009

Ans. B: Nasopharyngeal carcinoma with metastasis Causes of Homer's syndrome: First-order neuron lesions - Arnold-Chiari malformation - Basal meningitis (e.g., syphilis) - Basal skull tumors - Cerebral vascular accident (CVA)/ Wallenberg syndrome (lateral medullary syndrome) disease (e.g., multiple sclerosis) - Intrapontine hemorrhage Neck trauma (e.g., traumatic dislocation of cervical veebrae, traumatic dissection of the veebral aery) - Pituitary tumor - Syringomyelia Second-order neuron lesions - Pancoast tumor (tumor in the apex of the lung - most commonly squamous cell carcinoma) - Bih trauma with injury to lower brachial plexus - Cervical rib Aneurysm/dissection of aoa - Nasopharyngeal carcinoma (involvement of cervical sympathetic chain) - Central venous catheterization Trauma/surgical injury (e.g., radical neck dissection, thyroidectomy, carotid angiography, coronary aery bypass graft) - Lymphadenopathy (e.g., Hodgkin disease, leukemia, tuberculosis, mediastinal tumors) - Neuroblastoma Third-order neuron lesions - Internal carotid aery dissection (associated with sudden ipsilateral face and/or neck pain) - Raeder syndrome (paratrigeminal syndrome) - Oculosympathetic paresis and ipsilateral facial pain with variable involvement of the trigeminal and oculomotor nerves - Carotid cavernous fistula Cluster/ migraine headaches - Herpes zoster Drugs (may cause symptoms similar to Horner syndrome and may affect any region) - Acetophenazine - Bupivacaine - Chloroprocaine - Chlorpromazine