National Board of Chiropractic Examiners (NBCE) Practice Test

Horner Syndrome typically presents with which type of reflex?

1. Babinski reflex

2. Cremasteric reflex

3. Achilles reflex

4. Pupillary reflex

The correct answer is: Babinski reflex

Horner Syndrome is characterized by a triad of symptoms resulting from disruption of sympathetic nerve pathways to the eye and surrounding structures. The classic symptoms include ptosis (drooping of the eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. The pupillary reflex, which is the narrowing of the pupil in response to light or accommodation, is significantly altered in Horner Syndrome. Specifically, the affected eye will exhibit miosis, reflecting the impaired sympathetic innervation. This is because the sympathetic pathway that dilates the pupil is disrupted, leading to an imbalance where the parasympathetic influence dominates, causing constriction. Understanding this, the pupillary reflex is the most relevant reflex associated with Horner Syndrome. The other reflexes mentioned — Babinski, cremasteric, and Achilles — are not primarily linked to the sympathetic nervous system nor do they specifically relate to the symptoms observed in Horner Syndrome. Each of these reflexes has its own clinical significance and anatomical pathways that do not connect with the presentation of Horner Syndrome. Thus, the correct association with Horner Syndrome is the pupillary reflex, which reflects the condition’s characteristic findings.