Longus Coli Inflammation as an Uncommon Cause of Horner's Syndrome

The oculosympathetic pathway originates in the hypothalamus, descends through the brainstem, exits the cervicothoracic junction, ascends up and over the lung, and along the carotid to the sudomotor fibers of the face, the pupillary dilators, and muller's muscle. Lesions at any point along this chain may cause ptosis, miosis, anhidrosis, classically known as Horner's Syndrome. The longus colli are weak cervical flexor muscles which abut the ascending sympathetic ganglia. Here we present a case of nonspecific longus colli inflammation likely secondary to motor vehicle accident as an uncommon cause of Horner's Syndrome. Longus colli injury during cervical spinal injury as well as a suspected paraspinal mass of the longus colli have both been previously reported. To the author's knowledge, this is the first case of bilateral asymmetric longus colli inflammation causing Horner's syndrome.