Horner's syndrome:

The course of the sympathetic supply may be interrupted at one of two main points:

• its origin: stroke, syrinx, tumour, encephalitis, multiple sclerosis (MS) plaque,

or anything else in the surgical sieve that might hit the brainstem

• the neck: carotid aneurysm, Pancoast tumour, or trauma

Third Nerve Palsy

the causesof a third nerve palsyare those that damage the origin of the

nerve in the midbrain (e.g. midbrain amyloid, MS, Weber’s syndrome), and those that

damage the nerve vasculature (e.g. diabetes, vasculitis due to systemic lupus erythematosus

[SLE], rheumatoid arthritis [RA], polyarteritis nodosa), and nerve compression and stretch

(e.g. posterior cerebral artery aneurysms, tumours). Transient and repetitive paroxysmal

third nerve palsies can occur with migraines.

Argyll Robertson pupil

was classically said to be due to

syphilis

but now, the commonest cause is

diabetes

mellitus.

Other aetiologies include: long-standing Adie’s syndrome, encephalitis, amyloidosis, midbrain tumours (e.g. pinealoma), sarcoidosis, Lyme disease, and the presence of chronic iritis.

Holmes–Adie pupil