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The prognostic value of concurrent Horner syndrome in extended Erb obstetric brachial plexus palsy
1Department of Obstetrics & Gynecology, King Saud University, Riyadh, Saudi Arabia amelelsayed62@hotmail.com.
Insights
Horner syndrome in infants with extended Erb palsy indicates a poorer prognosis for nerve recovery. This finding is crucial for understanding outcomes in neonatal brachial plexus injuries.
Area of Science:
- Pediatric Neurology
- Neonatal Care
- Orthopedic Surgery
Background:
- Extended Erb palsy is a common neonatal brachial plexus injury.
- Horner syndrome, characterized by ptosis, miosis, and anhidrosis, can co-occur with brachial plexus injuries.
Purpose of the Study:
- To investigate the prognostic value of Horner syndrome in infants diagnosed with extended Erb palsy.
- To determine if the presence of Horner syndrome impacts the spontaneous recovery rates of specific nerve functions.
Main Methods:
- A retrospective study involving 220 infants with extended Erb palsy.
- Infants were divided into two groups: those with concurrent Horner syndrome (n=11) and those without (n=209).
- Spontaneous recovery rates of elbow flexion and wrist extension were compared between the two groups.
Main Results:
- Infants with Horner syndrome showed significantly lower rates of good spontaneous recovery for elbow flexion (27% vs. 59%, P = .038).
- Recovery of wrist extension was markedly worse in infants with Horner syndrome, with a 0% good spontaneous recovery rate compared to 61% in the control group (P < .0001).
Conclusions:
- Concurrent Horner syndrome in infants with extended Erb palsy is a significant indicator of a poor prognosis.
- The presence of Horner syndrome suggests a more severe injury affecting the sixth and seventh cervical nerve roots, impacting functional recovery.
Abstract:
Horner syndrome may be seen in infants with extended Erb obstetric brachial plexus palsy. However, its prognostic value in these infants has not been previously investigated. A total of 220 infants with extended Erb palsy were included and divided into 2 groups: group I (n = 209) were infants with extended Erb palsy without Horner syndrome, and group II (n = 11) were infants with extended Erb palsy and concurrent Horner syndrome. The rate of good spontaneous recovery of elbow flexion was 59% in group I and 27% in group II, and the difference was significant (P = .038). The rate of good spontaneous recovery of wrist extension was 61% in group I and 0% in group II, and the difference as highly significant (P < .0001). Concurrent Horner syndrome in infants with extended Erb palsy may be considered as a poor prognostic sign for recovery of the sixth and seventh cervical roots.
