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.
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.
From Horner sydrome to Multiple sclerosis; a case report
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.
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.
Orman G, Akbaş Kocaoğlu F, Sungur G, Örnek F. Horner sendromundan Multiple Skleroza; bir olgu sunumu. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Mart 2018;51(1):77-78.