Clinical observation of concurrent Horner's sign in infants with obstetric brachial plexus palsy

Abstract

Objective To discuss the diagnostic value of concurrent Horner's sign in infants with obstetric brachial plexus palsy and discover the clinical characteristics of Horner's syndrome caused by C7 nerve root avulsion alone.Methods From January 2009 to July 2009,39 infants with OBPP were identified with concurrent Horner' s syndrome.Clinical signs of Homer's syndrome were recorded which include ipsilateral blepharoptosis,pupillary miosis and facial anhidrosis.Lesions of brachial plexus nerve roots were confirmed during the surgery by direct visualization and electrophysiology.After a period of 6-month follow-up,these signs were recorded again.Results The initial age of Horner's sign evaluation of these OBPP patients was(3.58 ±0.87)months.Average postoperative follow-up interval was(6.19 ± 1.10)months.C7 nerve root avulsion alone was confirmed in 11 patients(case group),while the other 28 patients(control group)lind avulsion of at least one root of C8 and T1 nerve roots.There were not significant differences in anisocoria and blepharoptosis between the two groups(P ＞ 0.05).Facial gland secretary function was recovered more rapidly among patients in case group than their counterparts(P ＜ 0.05).Conclusion In newborns with OBPP,Horner' s syndrome can be correlated with C7 nerve root avulsion alone.No unique feature of Horner's syndrome which caused by C7 nerve root avulsion was found among patients of 3 months old. Key words: Brachial plexus; Child; Horner syndrome