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Bernard-Horner syndrome (Claude Bernard)

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A syndrome mainly characterised by a trias of miosis, ptosis, and enophthalmos. There is unilateral narrowing (partial ptosis) of the palpebral fissure, contraction of the pupil, enophthalmos and reduction of sweating on the ipsilateral side of the face and neck, transitory rise in facial temperature, lacrimation increased or decreased; facial hemiatrophy, and occasionally the development of cataracts; hemifacial anhidrosis (lesion below bifurcation of common carotic artery); depigmentation of iris (when syndrome occurs in children). Due to a lesion of the cervical sympathetic nerve trunk. Inheritance of congenital, primary form is autosomal dominant.

Horner’s syndrome is present in Babinski-Nageotte syndrome, Cestan-Chenais syndrome, Wallenberg’s syndrome, Dejerine-Klumpke syndrome, Villaret’s syndrome, and Raeder’s syndrome.

The syndrome was first described in animal-experiments as early as in 1727 by François Pourfour du Petit (1664-1741). By cutting the intercostal nerves in the neck of dogs, Pourfour du Petit had found that disturbances occurred in the eyes and face on the same side; this disproved earlier views of the cerebral origin of the intercostal nerves. The British physician Edward Selleck Hare (1812-1838) (9b: Sellick) in 1838 gave a less impressive description of a man with a tumour in the cervical region. It was more thoroughly described by Claude Bernard in 1852. A clinical report of the syndrome in a man shot through the throat was rendered in 1864 by the three American army physicians Silas Weir Mitchell (1829-1914), who had been influenced by Bernard; William Keen Jr. (1837-1932), and George Read Morehouse (1829-1905). Later descriptions by Jonathan Hutchinson in 1865, and in 1869 Horner wrote and account of a woman aged 40 years who developed the classical manifestations of the syndrome.

Gairdner (probably Sir William Tennant Gairdner (1824-1898) and John William Ogle (1824-1905), both English, also published cases, in 1855 and 1858, respectively. D. G. Durham in 1958 documented a family in which five persons in two generations of a family were affected. This rare genetic form is probably an autosomal dominant trait.

In English-speaking countries the term Horner’s syndrome is commonly used, while in France the term Bernard-Horner syndrome is common.

Von Passow’s syndrome is an association of Horner syndrome with heterochromia iridis.


  • François Pourfour du Petit:
    Mémoire dans lequel il est démontré que les nerfs intercostaux fournissent des rameaux que portent des esprits dans les yeux.
    Hist Acad roy Sci. (Paris), (Mém), 1727: 1-19.
  • E. S. Hare, in:
    London Medical Gazette, 1838-1839, 1: 16-18.
  • J. W. Ogle:
    On connexion between pupil of the eye and spinal cord.
    Medico-Chirurgical Transactions, London, 1857-1858.
  • C. Bernard:
    Leçons sur la physiologie et la pathologie du système nerveux, 1858, 2: 473-474. Des phénomènes oculo-pupillaires produits par la section du nerf sympathique cervical: ils sont indépendants des phénomènes vasculaires calorifiques de la tête.
    Comptes rendus de l’Académie des sciences, Paris, 1862, 55: 381-388.
  • S. Weir Mitchell, W. Keen Jr., G. R. Morehouse:
    Gunshot Wounds and Other Injuries of Nerves.
    Philadelphia, Lippincott, 1864.
    Reprinted, San Francisco, Norman Publishing, 1989.
    In this classic work the entity causalgia was given its place in medicine.
  • J. F. Horner:
    Über eine Form von Ptosis.
    Klinische Monatsblätter für Augenheilkunde, Stuttgart, 1869, 7: 193-198.
  • A. von Passow:
    Okulare Paresen im Symptomenbilde des "Status dysraphicus", zugleich ein Beitrag zur Ätiologie der Sympathikusparese (Horner-Syndrom und Heterochromia iridis).
    Münchener medizinische Wochenshrift, 1934; 74: 1243-1249.
  • D. G. Durham:
    Congenital hereditary Horner's syndrome.
    Archives of Ophthalmology, Chicago, 1958, 60: 939-940.

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