![Figure 1.](http://www.neurores.org/tables/jnr284w-g001.jpg)
Figure 1. Photographs displaying right side Horner’s syndrome with right hemifacial anhidrosis and left hemihyperhidrosis. Partial eyelid ptosis and meiosis was also observed (a). Acute colonic pseudo-obstruction (b) coronal abdominal computed tomography. Schematic illustrating the pathophysiology behind the concomitant occurrence of central Horner’s syndrome, limb dystonia, colonic pseudo-obstruction and PSH (c). A mesencephalic lesion causes disruption of the hypothalamospinal sympathetic pathway produces Horner’s syndrome and according to the EIR model, loss of normal tonic inhibition of spinal centers from the brainstem (dotted-arrow). Due to this disinhibition minor afferent stimulation (white arrow) elicits spinal allodynia and diffuse spinal cord excitation (black arrow) with PSH (SC, spinal cord center).
![Figure 2.](http://www.neurores.org/tables/jnr284w-g002.jpg)
Figure 2. MRI showing evidence of right cerebral peduncle and lateral tegmental injury of the mesencephalon ((a) white arrow, axial T2 sequence; (b) fluid attenuated inversion recovery FLAIR sequence; (c) diffusion-weighted imaging). Injury as a result of downward transtentorial herniation leading to injury of the hypothalamospinal sympathetic tract ((d) white arrowhead, coronal T2; (e) gray arrow, coronal FLAIR; (f) gray arrowhead, sagittal, FLAIR).