Positive apraclonidine test 36 hours after acute onset of horner syndrome in dorsolateral pontomedullary stroke.
A 40-year-old man developed a Horner syndrome as part of a dorsolateral medullary brainstem infarction. Thirty-six hours after the onset of the stroke, topical instillation of 0.5% apraclonidine produced reversal of anisocoria. This is the first case in which apraclonidine testing has been applied to a patient with a Horner syndrome caused by a lesion in the first segment of the oculosympathetic pathway and the shortest reported interval between clinical manifestations of the lesion and apraclonidine-induced reversal of anisocoria. A review of all reported cases of apraclonidine testing in Horner syndrome suggests that this is a promising diagnostic adjunct that must be validated in larger studies.
Lebas
Maud
M
Department of Ophthalmology, Hôpital Delafontaine, Saint-Denis, France. maudjacob@gmail.com
Seror
Julien
J
Debroucker
Thomas
T
D000316:Adrenergic alpha-Agonists; D000328:Adult; D003000:Clonidine / Q000031:analogs & derivatives*; D006732:Horner Syndrome / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D011149:Pons / Q000473:pathology*; D020521:Stroke / Q000150:complications / Q000473:pathology*
D000316:Adrenergic alpha-Agonists; C016986:apraclonidine; D003000:Clonidine