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  • Title: Positive Apraclonidine Test in Horner Syndrome Caused by Thalamic Hemorrhage.
    Author: Kauh CY, Bursztyn LL.
    Journal: J Neuroophthalmol; 2015 Sep; 35(3):287-8. PubMed ID: 25768246.
    Abstract:
    Reversal of anisocoria following instillation of apraclonidine 0.5% has been reported in Horner syndrome caused by lesions of the central and peripheral nervous system. The shortest documented latency between symptom onset and a positive apraclonidine test is 36 hours, occurring in a patient with a pontomedullary infarct. We present the case of a 69-year-old man with Horner syndrome due to thalamic hemorrhage in whom apraclonidine testing demonstrated reversal of anisocoria 4 days after symptom onset. This is the first reported case of a positive apraclonidine test in a Horner syndrome caused by a lesion at this site. It suggests that apraclonidine testing is useful in confirming the diagnosis within days of onset even in a lesion located at the most proximal portion of the oculosympathetic pathway.
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