No abstract available.
Clonidine ; Horner Syndrome ; Meningitis, Viral

An 11-year-old girl underwent T4 to L1 posterior instrumented scoliosis correction for adolescent idiopathic scoliosis. Postoperative clinical examination revealed left-sided Horner's syndrome which was preceded by left-sided C8 paraesthesia. The Horner's syndrome resolved after 14 hours following weaning and removal of the epidural catheter. Horner's syndrome following posterior instrumented scoliosis correction associated to epidural use is extremely rare. Surgeons must be aware of the risks of epidural placement and the need for close monitoring of associated complications. Alternative aetiology producing a Horner's syndrome must always be considered because of its devastating long term sequela if missed.
Adolescent ; Catheters ; Child ; Female ; Horner Syndrome* ; Humans ; Scoliosis* ; Weaning

No abstract available.
Horner Syndrome* ; Intervertebral Disc Displacement ; Spinal Cord Compression*

BACKGROUND: A definitive cure for an essential hyperhidrosis can be obtained by an upper thoracic sympathectomy. However, this is offset by the occurrence of a compensatory hyper hidrosis as a side effect and it is irreversible. We performed a thoracoscopic sympathetic chain block using an endoscopic clip in order to avoid the compensatory hyperhidrosis. MATERIAL AND METHOD: From Aug. 1998 to Nov. 1998, 42 cases of thoracoscopic clipping of the T2 sympathetic chain were performed. The sympathetic chain was clipped using an endoscopic clip instead of cutting. RESULT: Bilateral procedure took less than 40 minutes and occasionally necessitated one night in the hospital. There were no mortality nor life- threatening complications. Horners syndrome occurred in two cases. At the end of postoperative follow-up(median 3 months), 95.0% of the patients were satisfied with the results. Compensatory sweating occurred in 31 cases(77.5%) where nine of those cases were classified as either embarrassing(6 cases-15.0%) or disabling(3 cases-7.5%). CONCLUSION: Endoscopic thoracic T2 sympathetic chain block using endoscopic clipping is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis and the results were similar to those underwent T2 sympathicotomy. We recommend that patients receive endoscopic sympathetic chain block in summer.
Horner Syndrome ; Humans ; Hyperhidrosis* ; Mortality ; Sweat ; Sweating ; Sympathectomy

BACKGROUND: The ultrasound guidance in regional nerve blocks has recently been introduced and gaining popularity. Ultrasound-guided supraclavicular block has many advantages including the higher success rate, faster onset time, and fewer complications. The aim of this study was to examine the clinical data according to the varied volume of local anesthetics in the ultrasound-guided supraclavicular block. METHODS: One hundred twenty patients were randomized into four groups, according to the local anesthetic volume used: Group 35 (n = 30), Group 30 (n = 30), Group 25 (n = 30), and Group 20 (n = 30). Supraclavicular blocks were performed with 1% mepivacaine 35 ml, 30 ml, 25 ml, and 20 ml, respectively. The success rate, onset time, and complications were checked and evaluated. RESULTS: The success rate (66.7%) was lower in Group 20 than that of Group 35 (96.7%) (P < 0.05). The average onset times of Group 35, Group 30, Group 25, and Group 20 were 14.3 +/- 6.9 min, 13.6 +/- 4.5 min, 16.7 +/- 4.6 min, and 16.5 +/- 3.7 min, respectively. There were no significant differences. Horner's syndrome was higher in Group 35 (P < 0.05). CONCLUSIONS: In conclusion, we achieved 90% success rate with 30 ml of 1% mepivacaine. Therefore, we suggest 30 ml of local anesthetic volume for ultrasound-guided supraclavicular block.
Anesthetics, Local ; Horner Syndrome ; Humans ; Mepivacaine ; Nerve Block

Stellate ganglion block, due to its wide range of indications, is the most widely practiced procedure in pain clinics. We experienced the case of a 44-year-old female patient who developed prolonged Horner's syndrome after the use of stellate ganglion block. The patient recovered spontaneously from the Horner's syndrome after 12 months. If Horner's syndrome should occur, its etiology will need to be assessed. It is also important to assure the patient they will recover from the complication within a year.
Adult ; Female ; Horner Syndrome* ; Humans ; Pain Clinics ; Stellate Ganglion*

Body lateropulsion is a common manifestation of lateral medullary infarction (LMI), and usually associated with vertigo, limb ataxia, sensory disturbance, and Horner's syndrome. However, isolated body lateropulsion as a presenting symptom of LMI is rare, and the responsible lesion for lateropulsion remains uncertain. We report a 71-year-old woman who showed isolated body lateropulsion as a presenting symptom of LMI. Ipsilateral body lateropulsion in our patient may be ascribed to the involvement of the ascending dorsal spinocerebellar tract rather than the descending lateral vestibulospinal tract, which runs more ventromedially.
Ataxia ; Female ; Horner Syndrome ; Humans ; Infarction ; Spinocerebellar Tracts ; Vertigo

Pericarotid syndrome is the combination of a postganglionic Horner's syndrome and ipsilateral head and facial pain, which is caused by diverse pathologic processes in and around the internal carotid artery. We report a case of peri-carotid syndrome which presented Horner's syndrome and ipsilateral periodic severe hemicrania associated with malig-nant lymphma lapping internal carotid artery. After surgical removal of the mass and chemotherapy, miosis, ptosis, and ipsilateral hemicrania improved.
Carotid Artery, Internal ; Drug Therapy ; Facial Pain ; Head ; Headache ; Horner Syndrome ; Lymphoma* ; Miosis ; Pathologic Processes

Arterial dissection is an important cause of stroke. We report two cases of isolated posterior inferior cerebellar artery (PICA) dissection diagnosed by high-resolution vessel-wall MRI (HRVW-MRI). One subject complained of abrupt-onset vertigo and headache, and the other subject had headache, vertigo, and Horner syndrome. Conventional MRA showed only focal dilatation of the PICA, but HRVW-MRI revealed intramural hematoma and double-lumen contour in the PICA, suggesting arterial dissection. We suggest that the use of HRVW-MRI should be considered when diagnosing isolated PICA dissection in a PICA infarct with an unknown cause.
Arteries* ; Dilatation ; Headache ; Hematoma ; Horner Syndrome ; Magnetic Resonance Imaging* ; Pica ; Stroke ; Vertigo

To define the effect of alkalinization of bupivacaine 0.5% in supraclavicular approch of brachial plexus bock, the onset of sensory and motorblock were determined. Fourty physical status ASA 1 were randomly allocated to two groups.: Group 1 (n=20); bupivacaine 0.5% 20 ml (pH 6.0-6.2). Group 2 (n=20); alkalinized buivacaine 0.5% 20 ml (pH 6.9-7.2). Onest of sensory blockade were determined by pinprick in the C4 - T2 skin dermatome, and extend of sensory block was assessed by the number of dermatomes blocked while motor blockade was assessed by scoring on a scale: Grade 1; inability to flex the elbow against resistance. Grade 2; inability to flex the elbow against gravity. Grade 3; inability to flex the wrist against gavity. The results were as follows. 1) The average time for sensory blockade of five dermatonies was significantly more rapid in group 2 (within 15 min) than those in group 1 (over 25 min). 2) The average time of motor blockade was significantly more rapid in group 2 (Grade 1: 2 min 43 sec, Grade 2: 11 min 36 sec) than those in group 1 (Grade 1: 5 min 4 sec, Grade 2: 18 min 36 sec). 3) There was no pneumothorax, phrenic nerve paralvsis and general seizure or other side effects but Horners syndrome in 10 cases and hematoma in 2 cases were observed. The results indicate that alkainized bupivacaine for supraclavicular approch of rachial plexus block has more rapid onset than plain bupivacaine.
Brachial Plexus* ; Bupivacaine* ; Elbow ; Gravitation ; Hematoma ; Horner Syndrome ; Phrenic Nerve ; Pneumothorax ; Seizures ; Skin ; Wrist