Horner's syndrome with ipsilateral vocal cord and phrenic nerve palsies

Two further cases of a recently described syndrome (Rowland Payne, 1981) constituting a triad of sympathetic ophthalmoplegia, phrenic nerve palsy and ipsilateral vagus or recurrent laryngeal nerve paralysis are described. This is a syndrome of signs, but hoarseness, dysphagia, dysaesthesia and pain in the ipsilateral shoulder may be associated symptoms. Development of this syndrome in patients with malignant disease does not necessarily signify a very grave prognosis.