Painful Horner Syndrome as a Presentation of Nasopharyngeal Carcinoma: A Carotid Dissection Mimicking Lesion

Horner syndrome refers to a set of clinical presentations resulting from disruption of sympathetic innervation to ocular and adnexa.; Classically, clinical triad consists of ipsilateral blepharoptosis, pupillary miosis and facial anhidrosis. The lesion responsible for Horner syndrome can occur anywhere along ocular sympathetic pathway. Ocular sympathetic denervation may signify the life-threatening causes such as carotid dissection, brainstem infarction and malignancies. A patient with painful oculosympathetic denervation, timely accurate investigation and diagnosis are essential.