Strowd Roy E, Scott Blake, Walker Francis O
Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Wilderness Environ Med. 2012 Jun;23(2):158-60. doi: 10.1016/j.wem.2012.02.004. Epub 2012 Apr 10.
Horner's syndrome involves a triad of eyelid ptosis, miosis, and facial anhidrosis that results from disruption of the oculosympathetic pathway. Acquired Horner's syndrome is associated with a variety of medical conditions including Pancoast tumor and carotid dissection. We report the unique case of a 47-year-old man presenting with Horner's syndrome 4 weeks after black widow spider envenomation. Workup did not reveal any alternative explanatory etiology. We hypothesize that late sequelae of black widow spider envenomation secondary to autonomic nerve injury or retrograde axonal transport after mechanical inoculation may have led to an acquired defect in the oculosympathetic pathway resulting in a Horner's syndrome. This case introduces a rare cause of Horner's syndrome and highlights the importance of environmental exposures in the evaluation of these patients.
霍纳综合征包括眼睑下垂、瞳孔缩小和面部无汗三联征，这是由眼交感神经通路中断引起的。后天性霍纳综合征与多种疾病有关，包括肺尖肿瘤和颈动脉夹层。我们报告了一例独特的病例，一名47岁男性在被黑寡妇蜘蛛咬伤4周后出现霍纳综合征。检查未发现任何其他可解释的病因。我们推测，黑寡妇蜘蛛咬伤继发于自主神经损伤或机械接种后逆行轴突运输的晚期后遗症，可能导致眼交感神经通路获得性缺陷，从而导致霍纳综合征。该病例介绍了霍纳综合征的一种罕见病因，并强调了环境暴露在评估这些患者中的重要性。
