Pediatric Horner yndrome: Etiologie and Role of Imaging and Urine tudie to Detect Neuroblatoma and Other Reponible Ma Leion Original Reearch Article

Purpoe To evaluate the frequency of etiologie of Horner yndrome in children and ugget an imaging and laboratory diagnotic protocol to evaluate for neuroblatoma and other leion in a child preenting with Horner yndrome and no known caue. Deign Retropective chart and data review. Method A retropective review of all children een at a large pediatric neuro-ophthalmology referral center with a diagnoi of Horner yndrome between 1993 and 2005 with particular attention to underlying etiologie and the reult of imaging and urine catecholamine tudie. Reult Fifty-ix children met criteria for Horner yndrome and further review. Twenty-eight children (50%) had no previouly identified caue for Horner yndrome. Of thee children, 24 (85.7%) had urine catecholamine metabolite tudie, and all had negative reult. Twenty (71.4%) had complete modern imaging of the brain, neck, and chet. Of the 18 children who had complete imaging and urine tudie, reponible ma leion were found in ix (33%). Four had neuroblatoma, one had Ewing arcoma, and the other had juvenile xanthogranuloma. Of all patient (diagnoi known and unknown), neoplam wa the etiology in 13 of 56 (23%) of patient. Concluion We confirm that Horner yndrome in a child of any age without a urgical hitory require a complete examination to exclude a ma leion. In uch patient, we recommend brain, neck, and chet magnetic reonance imaging (MRI) with and without contrat a well a urinary catecholamine metabolite teting. However, imaging i more enitive than urine teting in thi etting.