American Orthoptic Journal

Am Orthopt J  50:107-114 (2000).

Pediatric Horner Syndrome: A Case Report and Review of the Literature

Bradley V. Davitt, M.D.
Oscar A. Cruz, M.D.

Horner syndrome is relatively uncommon among the pediatric population. As in adults, Horner syndrome is caused by a lesion affecting the sympathetic innervation of the lids and pupil. Clinical signs may include relative unilateral miosis, ptosis, anhydrosis and heterochromia. In children, these signs may be more difficult to appreciate due to poor patient cooperation or frequent periods of sleep. The clinical evaluation and management of the pediatric patient with Horner syndrome varies among clinicians. However, most would agree on the importance of differentiating acquired from congenital Homer syndrome in order to guide the diagnostic work up. Etiologies of pediatric Horner syndrome have not been as well described as in adults. The following case report highlights some of the typical dilemmas in the evaluation of these cases as well as an unusual complication.