Congenital Horner's syndrome
J. M. Weinstein, T. J. Zweifel and H. S. Thompson
Patients with congenital Horner's syndrome (who seemed, on the basis of
their clinical history and the distribution fo anhidrosis, to have a
preganglionic lesion) had partial mydriatic failure with hydroxyamphetamine
hydrobromide and a supersensitivity to phenylephrine hydrochloride. This
apparent paradox can be readily explained by postulating an aorthograde
transsynaptic dysgenesis of the postganglionic neuron, such as has been
demonstrated in the sympathetic nervous system of newborn animals. The
failure of hydroxyamphetamine to cause mydriasis indicates damage to the
postganglionic sympathetic neuron, but in the neonate this damage may be
secondary to a preganglionic lesion.
