Transient Horner's syndrome in a trauma patient with thoracic epidural analgesia: a case report.
Homer's syndrome, which classically presents as ipsilateral ptosis, meiosis, and facial anhydrosis, may present as a consequence of thoracic epidural analgesia. Pain that limits the patient's ability to maintain adequate pulmonary mechanics may optimally be treated with a thoracic epidural. The importance of recognition of a Horner's syndrome in such a patient is critical in preventing unnecessary anxiety for the patient and potentially embarking on an unnecessary diagnostic workup. The following is a case presentation of a patient who sustained multiple rib fractures in an automobile accident. The patient presented with a Horner's syndrome after a thoracic epidural infusion had begun. This article highlights the importance of early recognition of this benign, transient syndrome and discusses the pathways and potential mechanism of this process.
Menendez
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Department of Surgery, Eastern Virginia Medical School, Norfolk, Virginia 23507-1912, USA.
MacMillan
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DT
Britt
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LD
D000063:Accidents, Traffic; D015360:Analgesia, Epidural / Q000009:adverse effects*; D006732:Horner Syndrome / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors