Original articles

Pharmacologic testing in Horner's syndrome – a new paradigm

Derrick P Smit


For more than three decades, topical cocaine has been used to confirm the diagnosis and hydroxyamphetamine to localise the causative lesion in oculosympathetic palsy or Horner’s syndrome. More recently, other drugs have demonstrated the ability to point to the diagnosis or anatomical site. Apraclonidine and phenylephrine, given their similar diagnostic efficacy and increased availability, may have superseded cocaine and hydroxyamphetamine as first-line pharmacological testing agents in Horner’s syndrome.

Author's affiliations

Derrick P Smit, Division of Ophthalmology, Faculty of Health Sciences, Stellenbosch University, Western Cape, South Africa

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Horner syndrome; cocaine; hydroxyamphetamine; apraclonidine; phenylephrine; pholedrine

Cite this article

South African Medical Journal 2010;100(11):738-740.

Article History

Date submitted: 2009-09-15
Date published: 2010-11-09

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