Acquired Horner Syndrome in a Mother and Daughter

Abstract

A 41-year old right handed white woman woke up with a dull, pressure -like headache in the right orbit. While she was putting on her makeup, she noticed drooping of her right upper eye lid. Her headache did not interfere with her activities of daily living. She thought she was experiencing a “sinus headache”. She does not recall when her headache went away but denies taking any medications for it. She denied any other associated symptoms with this episode.

One week following this episode, the patient experienced the “worst headache of her life” and went to the hospital for further evaluation. Her ophthalmologic and neurologic exams were normal except for a right Horner syndrome.

The patient's evaluation included an MRI/MRA of the brain, a four vessel angiogram, a CT of the chest, and an MRI of the cervical and thoracic spine, all of which were normal. The mother of the patient had also developed a Horner syndrome at a similar age. Familial congenital Horner syndrome has been described in the literature. To our knowledge, this represents the first case report of familial acquired Horner syndrome.

Keywords:

• horner syndrome
• ptosis
• miosis