title: Early diagnosis of Horner syndrome using topical apraclonidine.
abstract: The diagnosis of Horner syndrome (HS) using apraclonidine eye drops is an alternative to the use of topical cocaine drops. A number of reports have described the efficacy of apraclonidine testing, but there is some debate over its sensitivity in the acute setting. We describe a patient with HS secondary to carotid dissection who had a positive response to apraclonidine 3 hours after the onset of symptoms. The case is made for a larger study of apraclonidine use to determine its true sensitivity and specificity, identify confounding factors, and redefine the criteria for positive testing.
authors.affiliation: Department of Neurology, Sheffield Teaching Hospitals NHS Trust, University of Sheffield, Sheffield, United Kingdom. j.cooper-knock@sheffield.ac.uk
authors.forename: Johnathan
authors.initials: J
authors.lastname: Cooper-Knock
authors.forename: Irene
authors.initials: I
authors.lastname: Pepper
authors.forename: Timothy
authors.initials: T
authors.lastname: Hodgson
authors.forename: Basil
authors.initials: B
authors.lastname: Sharrack
mesh_terms: D000287:Administration, Topical; D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D015875:Anisocoria / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D003000:Clonidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D042241:Early Diagnosis; D006732:Horner Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007498:Iris / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology; D008297:Male; D011859:Radiography
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; C016986:apraclonidine; D003000:Clonidine