Horner’s Syndrome

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Horner’s Syndrome and Your Baby

Learn more about this life-long condition

Horner’s syndrome is a debilitating condition that affects the eyes and the facial muscles. It is a symptom of a deeper medical problem that has damaged the sympathetic nerves. When these nerves function correctly, they enable the brain and face to communicate signals to each other unhindered. Other names sometimes used for this disorder include von Passow syndrome, Horner syndrome, Bernard-Horner syndrome, and oculosympathetic palsy.

Horner’s syndrome affects approximately 1 out of every 6,250 babies born.

Visual symptoms of Horner’s syndrome

Some of the visual characteristics accompanying Horner’s syndrome include:

  • A sinking eye on the affected side (enophthalmos)
  • A drooping eyelid on the affected side (most often the upper lid, but sometimes only the lower lid) (ptosis)
  • Eyes having different colored irises (beginning in children less than two years of age) (heterochromia)
  • A constricted eye pupil on the affected side (miosis)
  • Minimal sweating on the affected side (anhidrosis)

Vision is not often affected by the symptoms. However, other serious conditions may be the cause of the damage associated with the symptoms. Some infants who have congenital Horner’s syndrome may only experience one of the above symptoms, and the symptoms may occur sporadically. In such cases, it can be difficult for physicians to properly diagnose Horner’s syndrome.

Horner’s syndrome in newborns

Horner’s syndrome may develop for a variety of reasons, including:

  • Spinal cord injury
  • Stroke
  • Birth trauma
  • Other injuries causing damage to the nerves

Many times, when newborns have Horner’s syndrome, it is due to a brachial plexus injury.

Birth trauma can inflict damage to the nerves of the face and neck, resulting in Horner’s syndrome. The use of excessive traction during the birthing process when delivering the baby’s head and shoulders can inflict a birth trauma leading to Horner’s syndrome.

At the top of the spinal cord and around the base of the neck, there is a network of nerves referred to as the brachial plexus. This network of nerves is responsible for transmitting signals back and forth between the brain and the shoulders, arms, and hands. When these nerves are damaged through scarring, rupturing, pooling, or stretching from their anchorage in the spinal cord, the child can experience paralysis in the arm which is referred to as Erb’s palsy, Klumpke’s palsy, or a global brachial plexus injury. Horner’s syndrome may also develop when there is severe nerve damage involved.

A child who has symptoms of Horner’s syndrome will often experience these symptoms on one side of the face – the side that also affects the mobility of the arm and shoulder.

Treatment of Horner’s syndrome

Currently there is no medical cure for Horner syndrome. The type of treatment employed depends on the underlying reason for the disorder and the prognosis for recovery. Prompt diagnosis is vital in order to begin treatment as early as possible.

Visual symptoms often enable effective diagnosis of Horner’s syndrome. Evidence of the syndrome may be detected through a physical exam and pupil dilation test in which the pupil is evaluated as it responds to stimuli. In some cases additional testing may be required involving an X-ray or MRI to detect damage to the brachial plexus.

The treatment for Horner’s syndrome often is directed toward solving the primary medical issue involved. If Horner’s syndrome is due to a brachial plexus injury, medical professionals may focus their attention on helping the nerves to heal. Although, brachial plexus nerves may heal without surgery after period of time, sometimes surgery is necessary. This may involve a nerve grafting or nerve transplant procedure in which nerves from another location in the body are taken and used to rebuild or replace damaged nerves in the brachial plexus.

At times, the symptoms of Horner’s syndrome last an entire lifetime even after surgery has been performed. If the child’s vision has been affected by Horner’s syndrome, an ophthalmologist may be able to offer solutions.

Liability for Horner’s syndrome

When medical professionals fail to provide proper care for the baby or mother during the process of labor, birth trauma can result. Mistakes that result in stretching of the brachial plexus nerves, or even worse, rupturing or tearing of the nerves from the spinal cord – a condition referred to as avulsion – can lead to Horner’s syndrome and involve medical negligence and malpractice. Some of the errors that can damage the brachial plexus nerves and result in Horner’s syndrome include:

  • Excessive force applied during the delivery process – including malpractice in the use of vacuum or forceps that result in damage to the nerves
  • When the baby shoulder becomes trapped during delivery underneath the mother’s pubic bone (Shoulder dystocia)
  • Failure to act promptly to deliver a breech baby
  • Failure to respond to indications of maternal or fetal distress or schedule a timely C-section

If your child develops Horner’s syndrome after a difficult labor, it’s important to determine if medical care professionals failed in their obligation to provide a reasonable level of care for your baby during the birthing process. The doctor or other medical professionals may be held negligent if no other reasonably competent doctor would have performed the same way or made the same mistakes or omissions during delivery.

If your child has suffered one of various injuries during the birthing process, including Horner’s syndrome, you may have a claim of medical malpractice if the fault for the injury or condition rests with the doctor, caregiver, or other healthcare professionals. These healthcare providers may be held responsible for negligence and malpractice by providing compensation to injured victims.

These are many of the injuries our clients’ children have sustained

Cognitive, Developmental and Intellectual DisabilitiesInfant Spina Bifida
Brachial Plexus Injuries, Klumpke’s Palsy and Erb’s PalsyInfant Spinal Cord Damage
Cerebral PalsyInfant Subconjunctival Hemorrhage
Hypoxic Ischemic EncephalopathyNeonatal Hyperbilirubinemia
Intracranial HemorrhageKernicterus
Shoulder DystociaNeonatal Stroke and Infant Brain Ischemia
Epidural Birth InjuriesPersistent Pulmonary Hypertension of the Newborn (PPHN)
Horner’s SyndromeVacuum Extraction Injury
HydrocephalusWrongful Birth
Infant Bell’s PalsyUmbilical Cord Prolapse
Infant Broken Bones and Skull FracturesVacuum Extraction and Forceps Injuries
Infant Cervical Dystonia / Infant Torticollis / Infant Dystonia DisorderMeconium Stained Amniotic Fluid
Infant Meningitis

Legal help after your baby’s birth injury

If birth trauma is responsible for your child developing Horner’s syndrome, an experienced birth injury attorney from our team at Crandall & Pera Law can investigate the case of your baby’s injury. We can determine if you are eligible for compensation due to the medical negligence or malpractice of those trusted with the care of your infant during labor and delivery. To schedule a free consultation in Ohio or Kentucky, call us today at 877.955.0020 or reach us through our contact form.