Central Versus Peripheral Horner Syndrome! - USMLE Forums
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Old 07-10-2012
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Question Central Versus Peripheral Horner Syndrome!

hi can any one help me with the concept of central and peripheral horners syndrome .... it is mentiones in kaplan anatomy videos , but im still not clear !

central ... is lesion in hypothalmicospinal pathway
peripheral ... esion from t1 to superior cervical ganglia

is that it , i guess symptoms are same

thanx in advance!
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Old 07-10-2012
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Essentially you are right but just to elaborate:

CENTRAL PATHWAY= Descending hypothalamic fibers course with lateral spinothalamic tract, in lateral part of brain stem and terminates on PREganglionic sympathetic neurons in spinal cord.


PERIPHERAL PATHWAY=PRE ganglionic fibers emerging from (T1) lateral gray horn travel in paravertebral sympathetic chain without synapsing and terminates in superior cervical ganglia .

POSTganglionic fibers emerging from superior cervical ganglia travels with the branches of carotid arteries to supply face, scalp& orbit(sweat glands,dilator pupillae,superior tarsal muscle).

LESION ANY WHERE IN CENTRAL AND PERIPHERAL PATHWAY WILL ALWAYS RESULT IN IPSILATERAL HORNERs' syndrome but since central pathway is in brain stem so it will also include cranial nerve and long tract lesions thus helping you to determine the level of injury in brain stem.

hope that helps
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Quote:
Originally Posted by offpiste View Post
Essentially you are right but just to elaborate:

CENTRAL PATHWAY= Descending hypothalamic fibers course with lateral spinothalamic tract, in lateral part of brain stem and terminates on PREganglionic sympathetic neurons in spinal cord.


PERIPHERAL PATHWAY=PRE ganglionic fibers emerging from (T1) lateral gray horn travel in paravertebral sympathetic chain without synapsing and terminates in superior cervical ganglia .

POSTganglionic fibers emerging from superior cervical ganglia travels with the branches of carotid arteries to supply face, scalp& orbit(sweat glands,dilator pupillae,superior tarsal muscle).

LESION ANY WHERE IN CENTRAL AND PERIPHERAL PATHWAY WILL ALWAYS RESULT IN IPSILATERAL HORNERs' syndrome but since central pathway is in brain stem so it will also include cranial nerve and long tract lesions thus helping you to determine the level of injury in brain stem.

hope that helps


yes , thankyou, u helped me make a good concept!
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  #4  
Old 07-11-2012
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My pleasure
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