Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Horner's Syndrome
It sounds as if you've had a rather rough time lately!!! Horner's syndrome in its full-blown form consists of 3 elements--- ptosis (droopy eyelid), meiosis (a small pupil), and anhidrosis (lack of sweating on affected side of face +/- body). It is caused by damage to fibers of the SYMPATHETIC NERVOUS SYSTEM, which is responsible for sweating, blood vessel regulation, and many other so-called "autonomic" functions of the body. In neck surgery, fibers from this system are rather easily damaged as they course wtihin a structure called the sympathetic chain ganglion, and/or as they course along or near the internal carotid artery. The vagus or 10th nerve, and the hypoglossal or 12th cranial nerve, are also easily damaged. Since you have had preexisting damage to at least one 9th and 10th nerve from your prior rhizotomy procedure, even relatively trivial damage to the 9th or 10th or 11th nerve on the other side could produce disproportionate symptoms like hoarseness, dysphonia (abnormal or dimished voice), trouble swallowing, and a host of other potential problems. I would not yet give up on hope for recovery, since often surgery merely stretches or partially damages nerves in a way that with time (typically weeks to months), things improve. If the trouble with the voice persists much longer, I would definitely advise you to see a neurologist. Also, watch out for HIGH BLOOD PRESSURE which can result from both-sided damage to the 9th and/or 10th cranial nerves, since they control its regulation. Glossopharyngeal neuralgia is relatively rare and is due most often to a small blood vessel pressing against part of the 9th cranial nerve as it exits the brain, and can be treated with an operation to place a sponge between the nerve and the blood vessel, or other techniques (like rhizotomy, which attempts to selectively damage pain-generating small fibers in the nerve while preserving larger fibers that subserve normal sensations like touch). I hope you find this information useful. If you would be interested in an evaluation at the Cleveland Clinic, the number is 1-800-223-2273 extension 45559; or (direct) (216)-444-5559. Information provided in the Neurology Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of your particular medical condition should be strictly in conjunction with your treating physician(s).
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