Monday, November 1, 2010

A video & picture of me, & more info about Horner Syndrome

Jeff recorded this video of me about a week ago. It's my introduction to the uncommon condition called Horner Syndrome.

I didn't say anything in my video about the third symptom that's usually mentioned, an absence of sweating on some areas of the affected side of the face, because unless it's deep summer or you're exercising a lot, you're not likely to notice it.

Because you can't really see my different-sized pupils in the video, here's another cropped photo of me, with my glasses on, that really shows the difference:

There are a handful of sites where I found helpful and interesting information when I started researching my symptoms, and then Horner Syndrome specifically. The main page for Horner Syndrome on the Mayo Clinic site is a very good place to start:

If you click from that first page over to "Causes," you'll see a few of the biggies (stroke, tumor, cluster or migraine headaches), but also this straightforward explanation of what the "sympathetic nerves" are, and why only one side of the face is affected:
Sympathetic nerves in your face don't pass directly from your brain to your face. Instead, they start in an area of your brain known as the hypothalamus, travel through the brainstem and then down your spinal cord to enter your chest. From your chest, they go back up your neck, next to the main arteries that deliver blood to your head (carotid arteries), into your skull and then to your eyes. If the nerves are injured at any point along this route, Horner syndrome can result. Signs and symptoms of Horner syndrome usually occur on only one the side of your face because separate sympathetic nerves control each side.

A good article from eMedicine with fairly technical/medical terms, but includes some historical information, and more details about physical characteristics and the wide range of causes -- including mine, carotid artery dissection:

A "Can you identify this condition?" piece from a Canadian medical journal:
(Note that the link on the "Answer" page goes to a different "Question," where you'll see a picture of "hairy tongue," which I am so glad I don't have! Blech!!)
(Citation: Johnson, Davin; and Sanjay Sharma. "Ophthaproblem: Can you identify this condition?" Canadian Family Medicine, Vol. 56, No. 5, May 2010, p.439ff)

This is the abstract for an article with the specified objective, "To demonstrate the importance of thorough investigation of patients with Horner syndrome, and to explain the relevant anatomy." It's a recent case study, as the article was just published this year.
(Full citation: Costello, D.; J. Salmon; C. Milford; P. Pretorius. "A rare cause of Horner Syndrome." The Journal of Laryngology & Otology (2010), 124: 925-927; Cambridge University Press)

A "pictorial essay" from a medical journal, with complicated medical terms and photos from radiology films. For the diehard medical buffs.
(Citation: Nagy, Aurangzeb N., et al. "Horner's Syndrome due to first-order neuron lesions of the oculosympathetic pathway." American Journal of Roentgenology, v. 169, no. 2, p. 581-584, 1997.)

The Genetic and Rare Diseases (GARD) Information Center, on the National Institutes of Health (NIH) website, has little info about Horner's, but links to a variety of other resources that might be helpful. I found the solid eMedicine link through this page, so it's worth a few minutes of poking around.
(Note that they use "Horner" on the page, but "Horner's" in the title and the url.)

The National Organization for Rare Disorders (NORD) has a short description of the syndrome, links to other entities that may also be helpful, and the option to purchase a full-text report for the not-too-bad price of $7.95. In spite of the limited info there, I'm including the link because I love this sentence:

The underlying causes can vary enormously, from a snake or insect bite to a neck trauma made by a blunt instrument.

That's right, almost anything might cause Horner's, so good luck figuring it out! ;-)

That's what I've got for now. I also found a handful of books through Google Books searches that helped me out, and a couple of informative YouTube videos as well. But, I'll try to share the best of those resources in subsequent posts. I'll also post more about the cause of MY case of Horner Syndrome, internal carotid artery dissection, as I learn more about it. I'm going to see a specialist at a Kansas City hospital in two days. So, more to follow, as I'm able to write and post it.

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