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Pediatric Horner syndrome.
A R Jeffery1, F J Ellis, M X Repka
1Department of Ophthalmology, University Hospitals of Cleveland/Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Ohio 44106, USA.
Summary
Pediatric Horner syndrome has congenital and acquired causes, with birth trauma being common in congenital cases. Acquired cases often indicate serious underlying conditions requiring thorough evaluation.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Horner syndrome in children presents unique diagnostic challenges.
- Understanding the causes of pediatric Horner syndrome is crucial for appropriate management.
Purpose of the Study:
- To define the etiologies of Horner syndrome in the pediatric population.
- To differentiate causes between congenital and acquired pediatric Horner syndrome.
Main Methods:
- Retrospective review of medical records for pediatric Horner syndrome patients (< 18 years).
- Data collected from pediatric ophthalmology services at two major referral centers.
Main Results:
- Seventy-three pediatric Horner syndrome patients were identified.
- Congenital Horner syndrome (42%) linked to birth complications; acquired Horner syndrome (42% post-surgery, 15% without surgery) associated with serious conditions like neuroblastoma.
- Neuroblastoma and other serious conditions were identified in both congenital and acquired cases.
Conclusions:
- Birth trauma history may obviate extensive workup for congenital Horner syndrome.
- Acquired pediatric Horner syndrome necessitates comprehensive evaluation due to frequent links with severe underlying diseases.
- Diagnostic decisions for congenital Horner syndrome without clear birth history should consider neuroblastoma incidence and clinical findings.