Course: Selfie-Induced Diagnostic Challenge in Horner Syndrome
CME Credits: 1.00
Released: 2023-10-30
An 18-year-old woman with neurofibromatosis type 1 and prior right brachial plexus neurofibroma resection reported intermittent unilateral facial flushing after exertion. Associated symptoms included a mild and intermittent dull pain in the right neck and shoulder region. The pain was worsened by raising the arm above the head and was relieved by rest. Her selfie images () submitted to the clinical team suggested left-sided pallor. However, right-sided miosis on physical examination and a growing right-sided thoracic outlet tumor on whole-body magnetic resonance imaging ( A) suggested a right-sided Horner syndrome underlying the Harlequin sign. A surgical scar from the previous right brachial plexus surgery served as a vital marker, identifying the true side of the pallor ( B).
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