False negative apraclonidine test in two patients with Horner syndrome

Détails

ID Serval
serval:BIB_9A1839C038C1
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
False negative apraclonidine test in two patients with Horner syndrome
Périodique
Klinische Monatsblätter für Augenheilkunde
Auteur(s)
Kawasaki A., Borruat F. X.
ISSN
0023-2165
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
225
Numéro
5
Pages
520-522
Langue
anglais
Résumé
BACKGROUND: Because of denervation supersensitivity, a miotic pupil in a sympathetically-denervated eye dilates in response to a dilute or weak alpha-1-agonist drug. A reversal of anisocoria after topical apraclonidine is considered as a positive test result that diagnoses a unilateral Horner syndrome. HISTORY AND SIGNS: Two women aged 34 and 46 years with a cocaine-confirmed oculosympathetic defect (Horner syndrome) were tested with 1 % topical apraclonidine on separate days. THERAPY AND OUTCOME: In one patient, her miotic Horner pupil dilated marginally but not enough to reverse the baseline anisocoria. Additionally, the upper lid on the same side retracted. There was no discernable effect of apraclonidine on the normal, contralateral eye. In the second patient, there was no pupillary response to apraclonidine but there was resolution of her ptosis. CONCLUSIONS: Neither patient demonstrated a reversal of anisocoria, the current criterion for diagnosing a Horner syndrome using apraclonidine. Thus, these two patients with an established oculosympathetic defect were said to have a "negative test" for Horner syndrome. Yet both women showed subtle pupil and/or lid changes in response to apraclonidine that were consistent with sympathetic denervation supersensitivity. Reversal of anisocoria following topical apraclonidine does not occur in all patients with a unilateral oculosympathetic defect and more specific parameters for defining a positive test result might optimize apraclonidine's utility as a diagnostic test for Horner syndrome
Mots-clé
Adrenergic alpha-Agonists , Adult , Aged , analogs & derivatives , Clonidine , diagnosis , diagnostic use , drug effects , Eye , False Negative Reactions , Female , history , Horner Syndrome , Humans , Middle Aged , Patients , Pupil , Switzerland , therapy
Pubmed
Web of science
Création de la notice
29/01/2009 22:12
Dernière modification de la notice
20/08/2019 15:01
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