Horner syndrome following a selective cervical nerve root block.

Area of Science:

• Neurology
• Pain Management
• Interventional Radiology

Background:

• Cervical degenerative disc disease is a common condition requiring pain management.
• Selective nerve root blocks are frequently employed for diagnosing and treating cervical radiculopathy.
• Potential complications, though rare, must be considered in interventional pain procedures.

Observation:

• A 31-year-old male patient developed right-sided ptosis and miosis after a right C7 selective nerve root block.
• Pharmacologic testing confirmed the presence of right Horner syndrome.
• Cervical MRI and MRA revealed no evidence of arterial dissection.

Findings:

• The case presents an unusual occurrence of permanent Horner syndrome following a selective cervical nerve root block.
• This suggests a potential iatrogenic cause for Horner syndrome related to the C7 nerve root block procedure.
• Absence of arterial dissection on imaging rules out vascular injury as the etiology.

Implications:

• This case underscores the importance of recognizing and managing potential neurological complications after cervical nerve root blocks.
• Awareness of this rare adverse event is crucial for clinicians performing these procedures.
• Further investigation may be warranted to understand the mechanism and minimize the risk of permanent Horner syndrome.