Horner sendromundan Multiple Skleroza; bir olgu sunumu

Öz

29 yaşında erkek hasta sağ gözün üst kadranında görmede bulanıklık ile başvurdu. Hastada anizokori ve sol gözünde 2 mm mevcuttu. Sağ pupil 3 mm, sol pupil 1,5 mm idi. Aproklonidin testi ile Horner sendromu tanısı konuldu. Kranyal MR’da periventriküler beyaz cevherde, ventriküler düzene dikey olarak hiperintens demiyelinizan plaklar görüldü. Hastaya nöroloji konsülte edildi; lomber ponksiyon ve radyolojik değerlendirme sonrası MS tanısı konuldu.
Bu olgu sunumunun önemi, anizokori önemli bir klinik bulgu olduğunu ve ayırıcı tanısının dikkatlice yapılmalı gerektiğini hatırlatmaktır. 

Anahtar Kelimeler

• Horner sendromu,Anizokori

From Horner sydrome to Multiple sclerosis; a case report

Öz

A 29 year-old male presented with vision blurred of superior quadrant in right eye. He had 2 mm left upper lid pitozis. He had anisocoria. Right pupil diameter was 3 mm, left pupil diameter was 1.5 mm. Apraclonidine test was performed and confirmed Horner syndrome in left side. At the level of centrum semiovale, in the periventricular white matter, perpendicular to the ventricular system, demyelinating plaques were observed in cranial MRI. Patient was consultated to neurology, LP and radiological evaluation were diagnosed with MS. This patient was diagnosed with MS with Horner syndrome. Anisocoria is an important finding and differential diagnosis should be done carefully.

Anahtar Kelimeler

• Horner sydrome,Anisocoria,Multiple sclerosis

Kaynakça

1. Referans 1. Davagnanam I, Fraser CL, Miszkiel K, Daniel CS, Plant GT. Adult Horner's syndrome: a combined clinical, pharmacological, and imaging algorithm. Eye (Lond). 2013 Mar;27:291-8. Referans 2. Sayan M, Celik A. The Development of Horner Syndrome following a Stabbing. Case Rep Med. 2014;2014:461787. Referans 3. Garg N, Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav. 2015;5(9):e00362. Referans 4. Brück W, Stadelmann C.The spectrum of multiple sclerosis: new lessons from pathology. Curr Opin Neurol. 2005;18:221-4.Referans 5. Saidha S, Syc SB, Ibrahim MA ve ark. Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography. Brain. 2011;134:518-33.