Assessment of the Prognostic Value of Horner Syndrome in Perinatal Brachial Plexus Palsy

Abstract

The aim of this study was to evaluate the prognostic value of Horner syndrome as an indicator of preganglionic injuries of the lower part of the brachial plexus. The study investigated 18 cases of children with perinatal brachial plexus injury and coexistent Horner syndrome. The following data sets were analyzed: the degree of severity of the brachial plexus injury, the results of imaging examinations, the intraoperative view, the kind of operative treatment and the resultant hand function. On the basis of a clinical material analysis, it was established that Horner syndrome accompanying upper and upper-middle brachial plexus injuries has no prognostic importance. In total injuries the presence of this syndrome is not a definite proof of preganglionic injury to the C8-Th1 roots of the spinal nerves.

Key words

perinatal brachial plexus lesions - spinal nerve root avulsion - Horner syndrome - preganglionic injuries

References

• 1 Al-Qattan MM, Clarke HM, Curtis CG. The prognostic value of concurrent Horner's syndrome in total obstetric brachial plexus injury.  J Hand Surg. 2000;  25B 166-167
• 2 Al-Qattan MM. Assessment of the motor power in older children with obstetric brachial plexus palsy.  J Hand Surg. 2003;  28B 46-49
• 3 Benjamin K. Injuries to the brachial plexus: mechanisms of injury and identification of risk factors.  Adv Neonat Care. 2005;  5 181-189
• 4 Benjamin K. Distinguishing physical characteristics and management of brachial plexus injuries.  Adv Neonat Care. 2005;  5 240-251
• 5 Chen L, Gao S, Gu Y. et al . Histopathologic study of the neuroma-in-continuity in obstetric brachial plexus palsy.  Plast Reconstr Surg. 2008;  121 2046-2054
• 6 Chuang DC, Mardini S, Ma HS. Surgical strategy for infant obstetrical brachial plexus palsy: experiences at Chang Gung Memorial Hospital.  Plast Reconstr Surg. 2005;  116 132-142
• 7 Chuang DC, Ma HS, Wei FC. A new evaluation system to predict the sequelae of late obstetric brachial plexus palsy.  Plast Reconstr Surg. 1998;  101 673-685
• 8 Eng GD, Binder H, Getson P. et al . Obstetrical brachial plexus palsy outcome with conservative management.  Muscle Nerve. 1996;  19 884-891
• 9 Gilbert A. Long-term evaluation of brachial plexus surgery in obstetrical palsy.  Hand Clin. 1995;  11 583-594
• 10 Haerle M, Gilbert A. Management of complete obstetric brachial plexus lesions.  J Pediatr Orthop. 2004;  24 194-200
• 11 Jeffery AR, Ellis FJ, Repka MX. et al . Pediatric Horner syndrome.  J AAPOS. 1998;  2 159-167
• 12 Waters PM. Update on management of pediatric brachial plexus palsy.  J Pediatr Orthop. 2005;  25 116-126

Correspondence