ORIGINAL RESEARCH Journal of Case Reports in Dental Medicine (J Case Rep Dent Med) May 2019, Volume 1, Number 2: 36-39 36 http://jcrdm.org © 2019 JCRDM. Published by Faculty of Dentistry, Hasanuddin University. All rights reserved. Objective: The current case series will discuss about two horner syndrome cases with a different pattern of anhydrotic. Methods: Male 54 years old came with punctured and burned pain sensation at left hand for the last one year which radiated along the shoulder toward the tip of left fingers. There were 10 kgs of weight loss. Neurological examination showed unequal pupil siｺe 2.5mm/ 1.5mm, left ptosis, left hemifacial and left arm anhidrosis. Cervical MRI showed burst fracture involved CV T1 pedicle. Results: Case I MSCT Thorax showed suspicious of neurogenic tumor which resulted in CV T1 destruction and case II MSCT thorax showed left lung collapse due to pleural effusion Conclusion: Anhidrotic pattern will be an essential factor in making a topical diagnosis for patients with Horner syndrome, which also can be a fundamental basis in choosing the next additional examinations required to find the etiology. Keywords: Anhidrotic pattern, Hornerﾒs syndrome, Sympathetic nerve Cite this Article: Basri MI, Wardani ｅ, Basir H, Wuysang AD. 2019. Localiｺe lesion of hornerﾒs syndrome based on anhydrotic pattern. Journal of Case Reports in Dental Medicine. 1(2): 36-39. DOI: 10.20956/jcrdm.v1i2.93 Localize lesion of hornerﾒs syndrome based on anhydrotic pattern Muhammad I. Basri, 1* Emy Wardani, 2 Hasmawaty Basir, 2 Audry D. Wuysang 2 Abstract Introduction Horner’s syndrome is a disorder of the sympathet- ic nerves in the eyes and face, consisting of three symptoms: miosis, ptosis, and anhidrosis. This syndrome was first discovered in animals by French physiologist Claude Bernard in 1854. But Johann Friedrich Horner, an ophthalmologist, was the first to describe it completely as a parese oculosympathetic in 1869. There are three types of Homer’s syndrome: central, preganglionic, and postganglionic. 1 Case Report The first order neuron lesion (central type) The axons of the first order neurons begin in the posterolateral hypothalamus region leading to the lateral region of the brain stem and ending at the ciliospinal center of Budge and Waller in the intermediolateral substance of the C8-T1 spinal cord. The most frequent lesions in the hypothalamus are tumors and bleeding, which can cause Horner’s syndrome with contralateral hemiparesis and contralateral hypesthesia. Lesions in the dorsal mes- encephalon region (pontomesencephalic junction) cause Horner’s syndrome accompanied by con- tralateral trochlear nerves. Wallenberg’s syndrome (lateral medulla stroke) is the most frequent etiology of this type. Other symptoms that can be found are ipsilateral ataxia and contralateral hypalgesia. The most common spinal cord region lesions that cause Horner’s syndrome are syringomyelia and spinal cord trauma. Other etiologies are myelitis, vascular malformations, demyelinating, tumor and infarction. 1 Department of Anatomy, Fac- ulty of Medicine, Hasanuddin University, Makassar, Indonesia 2 Department of Neurology, Faculty of Medicine, Hasanuddin Univer- sity, Makassar, Indonesia * Correspondence to: ikbal_fkguh@yahoo.com Received: 5 February 2019 Revised: 27 February 2019 Accepted: 10 March 2019 Available Online: 1 May 2019 cord trauma. Other etiologies are myelitis, vascular malformations, demyelinating, tumor and infarction. 1 The second order neuron lesion (preganglionic type) The neuron of the second order neuron of the sympathetic nerve exits from the ciliospinal center of Budge and Waller C8-T1, and then through the pulmonary apex, rises through stellate ganglion, enters to the carotid sheath and synapse in the superior cervical ganglion which located at the bifurcation level of common carotid artery. 1 Pulmonary apex lesions that press the superior thoracic outlet provide symptoms of Horner syndrome with ipsilateral shoulder pain, medial paresthesias of the arms and fingers IV-V, and weakness or atrophy of the palm muscle. All of these signs and symptoms are known as Pancoast syndrome. The most common cause of Pancoast syndrome is a non-small cell lung carcinoma. Patients with the preganglionic syndrome and ipsilateral shoulder pain should be investigated for suspicion of neoplasm. 1 The third order neuron lesion (postganglionic type) The neuron axons of the third order of sympathetic nerves originate from the superior cervical ganglion, travel upward with the internal carotid artery, and then to the cavernous sinus. Furthermore, the axon goes along with the abducent nerve and ophthalmic division