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. 2010 Mar;128(3):324-9.
doi: 10.1001/archophthalmol.2010.6.

Incidence of pediatric Horner syndrome and the risk of neuroblastoma: a population-based study

Stephen J Smith  1 , Nancy Diehl, Jacqueline A Leavitt, Brian G Mohney
Affiliations

Incidence of pediatric Horner syndrome and the risk of neuroblastoma: a population-based study

Stephen J Smith et al. Arch Ophthalmol. 2010 Mar.

Abstract

Objective: To describe the incidence of pediatric Horner syndrome and the risk of occult malignancy in a population-based cohort.

Methods: The medical records of all pediatric patients (aged <19 years) residing in Olmsted County, Minnesota, who received diagnoses of Horner syndrome from January 1, 1969, through December 31, 2008, were retrospectively reviewed.

Results: Horner syndrome was diagnosed in 20 pediatric patients during the 40-year period, yielding an age- and sex-adjusted incidence of 1.42 per 100 000 patients younger than 19 years of age (95% confidence interval [CI], 0.80-2.04). Eleven of the 20 patients (55%) had a congenital onset, for a birth prevalence of 1 in 6250 (95% CI, 3333-10 000), while the remaining 9 (45%) had acquired syndromes. Seven of the 11 (63.6%) patients with congenital cases had a history of birth trauma, while the remaining 4 (36.4%) had no identifiable cause. Six of the 9 (66%) acquired cases occurred following surgery or trauma, while the remaining 3 (33%) had no known etiology. None of the 20 patients (95% CI, 0.0%-16.8%) were found to have a neuroblastoma or other malignancy during a mean follow-up of 56.5 months (range, 0-256.9 months).

Conclusions: The incidence of pediatric Horner syndrome in this population was 1.42 per 100 000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. Birth, surgical, or other trauma occurred in 13 (65%) of the patients, while none were found to have an underlying mass lesion, suggesting a need for reappraising current recommendations for extensive evaluations in these patients.

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Figures

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Incidence of Horner syndrome by age at diagnosis in 20 pediatric patients (aged <19 years) who received diagnoses of Horner syndrome in Olmsted County, Minnesota, from 1969 to 2008
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Comment in

  • Pediatric horner syndrome.
    Liu GT, Mahoney NR, Avery RA, Menacker SJ, Wilson MC, Hogarty MD, Maris JM. Liu GT, et al. Arch Ophthalmol. 2011 Aug;129(8):1108-9; author reply 1109. doi: 10.1001/archophthalmol.2011.201. Arch Ophthalmol. 2011. PMID: 21825206 No abstract available.

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