Horner syndrome

Horner syndrome
confirm it is horner
"Everything is small"-ptosis,small pupil(miosis),anhydrosis and enolthalmos(occasionally)

proceed to horner protocol
check other cranial nerve to rule out Wallenberg(lateral medullary) syndrome, sensation 5th, facial nerve, gag reflex for 9th and 10th and cerebellar sign plus contralateral sensation .

If no, then look for radiation marking , wasting small muscle , dullness apical ocasionally engorged vessel (Superior vena cava obs) to suggest Pancoast tumour.

dissociated sensory loss and burn scar to suggest syringomyelia if gag reflex reduced than syringobulbia.

surgical scar at neck may suggeast injury to the T1 nerve.

Present the finding .
You should be safe for this station.
(P/S) may sure it is Horner before do all this.