Parents, have you ever heard of the term horner syndrome? This is a rare disorder that can affect your child’s eyes. In some cases, this syndrome has even appeared since the child was born.
Sometimes horner syndrome does not show significant signs. However, if your baby shows some symptoms that point to this syndrome, then proper treatment must be done immediately.
Definition of Horner’s Syndrome
Horner’s syndrome is a disorder that affects the eye and surrounding tissue on one side of the face and is the result of paralysis of certain nerves.
This syndrome can affect anyone, even toddlers. In about 5 percent of affected individuals, this disorder is present at birth (congenital).
Abnormalities in the eye area associated with Horner’s syndrome generally do not affect vision or health.
However, the nerve damage that causes this syndrome can be caused by other health problems, some of which can be life-threatening.
Symptoms of Horner’s Syndrome
Parents, pay attention if your children experience changes in their eyes. Typical physical signs and symptoms associated with Horner syndrome usually affect only one side of the face (unilateral).
Here are some symptoms that may appear in children with Horner’s syndrome:
- Drooping upper eyelid (ptosis).
- In some people, constricted pupils interfere with the ability to see in the dark.
- Slight elevation of the lower eyelid, sometimes called reverse ptosis.
- The pupils are constricted and consistently small (miosis).
- A marked difference in pupil size between the two eyes (anisocoria).
- Slight or delayed opening (dilation) of the affected pupil in dim light.
- Sunken appearance of the affected eye.
- Little or no sweating (anhidrosis) on the affected side of the face and it sometimes appears red.
- Retraction of the eyeball.
- If Horner’s syndrome occurs before the age of two, the colored part of the eye (iris) may be a different color (heterochromia iridis). In most cases, the iris on the affected side has no color (hypopigmentation).
- Additional signs and symptoms in children with Horner syndrome may include a lighter iris color in the affected eye in children under 1 year of age.
- A change in color on the affected side of the face that usually occurs due to heat, physical activity, or emotional reactions.
Causes of Horner’s Syndrome
Horner’s syndrome can occur due to many things. These causes include:
- Carotid artery dissection.
- Development of tumors in the neck or chest cavity, especially neuroblastoma and tumors of the upper part of the lung (Pancoast tumor).
- Development of lesions in the midbrain, brainstem, upper spinal cord, neck, or eye orbits.
- Inflammation or growth affecting the lymph nodes of the neck.
- Surgery or other forms of trauma to the neck or upper spinal cord.
- Disruption of the sympathetic nerve supply to the eye due to a lesion or growth.
- Inherited as an autosomal dominant genetic trait.
- Some cases of Horner’s syndrome occur for no other apparent reason or have an unknown cause (idiopathic).
While the most common causes of Horner’s syndrome in children include:
- Injury to the neck or shoulders during childbirth.
- The presence of an aortic defect at birth.
- Tumors of the hormonal and nervous systems (neuroblastoma).
- Genetic disorders .
Genetic diseases are determined by the combination of genes for a particular trait present on chromosomes received from the father and mother.
Chromosomes present in the nucleus of human cells carry genetic information for each individual. Human body cells usually have 46 chromosomes.
Human chromosome pairs are numbered from 1 to 22, and the sex chromosomes are named X and Y.
Males have one X and one Y chromosome, and females have two X chromosomes. Each chromosome has a short arm called “p” and a long arm called “q”.
Chromosomes are further divided into many numbered bands. For example, “chromosome 11p13” refers to band 13 on the short arm of chromosome 11. The numbered bands determine the location of the thousands of genes that are present on each chromosome.
All individuals carry some abnormal genes. Parents who are close relatives (consanguineous) have a higher chance than unrelated parents of both carrying the same abnormal gene, which increases the risk of having a child with a recessive genetic disorder.
Dominant genetic disorders occur when only one copy of the abnormal gene is needed for the disease to appear.
The abnormal gene may be inherited from one parent, or it may be the result of a new mutation (gene change) in the affected individual.
The risk of passing the abnormal gene from an affected parent to their offspring is 50% for each pregnancy, regardless of the sex of the resulting child.
Frequency of Occurrence
This syndrome is a rare syndrome whose frequency of occurrence is rare. Quoting fromMedline Plus, there are about 1 in 6,250 babies born with Horner’s syndrome.
The incidence of later onset syndrome is unknown, but it is considered an uncommon disorder.
Risk Factors
Horner syndrome is a rare disorder that affects males and females in equal numbers and can occur at any age, among any ethnic group in any geographic location.
Therefore, it does not have a tendency to increase a person’s risk of experiencing Horner’s syndrome.
Diagnosis
The doctor will perform a general medical examination to determine the diagnosis. After that, the doctor may perform tests to determine the nature of the symptoms and identify possible causes. The following tests may be performed:
Tests to Confirm Horner’s Syndrome
A doctor can diagnose Horner’s syndrome based on the child’s medical history and assessment of the symptoms experienced by the child.
In addition, an eye specialist can also confirm the diagnosis by administering eye drops to both eyes.
Including drops that will dilate the pupil of a healthy eye or drops that will constrict the pupil of a healthy eye.
By comparing the reaction in the healthy eye with the suspected eye, the doctor can determine whether nerve damage is the cause of the problem in the suspected eye.
The doctor will perform the test in two parts:
- First, the doctor will use eye drops containing a small amount of cocaine or another drug (apraclonidine) in both eyes.
- If Horner’s syndrome is possible, the doctor will do another test 48 hours later. He will give hydroxyamphetamine drops into both eyes.
How the pupils react to medication indicates whether Horner’s syndrome may be present and helps find where the problem is.
Tests to Identify the Location of Nerve Damage
The nature of the symptoms experienced by the child can help the doctor narrow down the search for the cause of this syndrome.
The doctor may also perform additional tests or order imaging tests to find lesions or irregularities that interfere with nerve pathways.
Next, your child’s doctor may order one or more of the following imaging tests to find the possible location of the irregularity causing Horner syndrome, including:
- Magnetic resonance imaging (MRI) , a technology that uses radio waves and magnetic fields to produce detailed images.
- Magnetic resonance angiography (MRA) , which is used to evaluate blood vessels.
- Chest X-ray
- Computerized tomography (CT) , a special X-ray technology.
Horner’s Syndrome Treatment
There is actually no specific treatment for Horner’s syndrome. Horner’s syndrome often resolves when the underlying medical condition is effectively treated.
Treatment for Horner syndrome depends on the location and cause of the lesion or tumor. In some cases, surgical removal of the lesion or growth may be appropriate. Methods such as radiation and chemotherapy may be beneficial for patients with malignant tumors.
In addition, genetic counseling is also beneficial for patients and families if the child has a genetic form of the disorder. Other treatments are symptomatic and supportive.
Prevention
To prevent children from getting this rare syndrome , avoid the underlying causes as much as possible.
One thing that parents can do is to undergo genetic counseling when planning a pregnancy. This can reduce the risk of a child being exposed to this syndrome due to hereditary disease.
Horner’s syndrome can also be caused by injury to the head and neck.
Therefore, parents must ensure to supervise their child’s activities so that their head does not suffer a serious injury that could cause this disorder to occur.
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Horner syndrome is a rare disorder that can affect anyone including your child. Continue to maintain his safety and health so that your child can avoid this syndrome.
Republished with permission from theAsianParent Indonesia
