title: Intermittent Horner's syndrome on alternate sides: a hint for locating spinal lesions.
abstract: A patient with a cervical intramedullary ependymoma is described who exhibited a Horner's syndrome on alternate sides. Pharmacological study demonstrated damage to the pre-ganglionic sympathetic neurons. Disregarding cases with the Shy-Drager syndrome, three comparable case reports have been found in the literature where the fluctuating expression of Horner's syndrome, alternating from one side to the other, was attributable to a lesion of the cervical spinal cord. In contrast to the present patient, the pharmacological responses of these patients indicated a lesion of the central sympathetic pathway.
mesh_terms: D000328:Adult; D001285:Atropine; D001339:Autonomic Fibers, Preganglionic; D003042:Cocaine; D004806:Ependymoma / Q000150:complications*; D004837:Epinephrine; D006732:Horner Syndrome / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D012025:Reflex, Pupillary; D013120:Spinal Cord Neoplasms / Q000150:complications*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
chemical_list: D001285:Atropine; D003042:Cocaine; D004837:Epinephrine