Acute Postpartum Horner's Syndrome due to Epidural Anesthesia

Jeret, Joseph S.

doi:10.1001/archopht.1995.01100050022016

Cited by 11 publications

(4 citation statements)

References 5 publications

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“…We note that although uncommon, many reports have been published in the Obstetrics and Gynaecology literature related to lumbar epidural placement in pregnancy, labour and caesarean sections causing Horner's syndrome. Anatomical and physiological changes during pregnancy and labour may explain the volume of reported to some degree, as changes in intra-abdominal pressure divert blood through the epidural venous plexus and subsequent reduced volume within the epidural space and increased pressures might lead to a more cranial distribution of epidural local anaesthetic [ 2 , 6 , 7 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Horner's Syndrome Secondary to Epidural Anaesthesia Following Posterior Instrumented Scoliosis Correction

2015

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An 11-year-old girl underwent T4 to L1 posterior instrumented scoliosis correction for adolescent idiopathic scoliosis. Postoperative clinical examination revealed left-sided Horner's syndrome which was preceded by left-sided C8 paraesthesia. The Horner's syndrome resolved after 14 hours following weaning and removal of the epidural catheter. Horner's syndrome following posterior instrumented scoliosis correction associated to epidural use is extremely rare. Surgeons must be aware of the risks of epidural placement and the need for close monitoring of associated complications. Alternative aetiology producing a Horner's syndrome must always be considered because of its devastating long term sequela if missed.

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Section: Discussionmentioning

confidence: 99%

Horner's Syndrome Secondary to Epidural Anaesthesia Following Posterior Instrumented Scoliosis Correction

2015

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“…Only one article was published in 1995[2] in the ophthalmology literature documenting Horner's syndrome, but during normal labor and delivery. Although the majority of the literature describes a transient phenomenon, rarely it may persist and require consideration of surgical intervention for ptosis.…”

Section: Discussionmentioning

confidence: 99%

“…Only one article describing Horner's syndrome during normal labor was published in the ophthalmology literature. [2] All of the other articles were found in the anesthesia, obstetrics, and neurology journals.…”

mentioning

confidence: 99%

Unusual case of persistent Horner′s syndrome following epidural anaesthesia and caesarean section

Goel

Burkat

2011

Indian J Ophthalmol

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This is a rare case of persistent Horner's syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) of head, neck, and chest were unremarkable. Medline search using terms Horner’s, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner's syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner's syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner's syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.

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“…We refer to case reports by Cowie et al [1], who described HS secondary to epidural anesthesia following posterior instrumented scoliosis correction, and Yang J and Cho et al [18], who described HS after spinal fusion secondary to epidural anesthesia. Transient HS has also been reported in several studies in patients who received epidural anesthesia, mostly after obstetric surgeries [19,20]. The explanation for epidurals and spinal anesthesia as a potential cause of HS may be that to perform this anesthesia, a local anesthetic must be injected near the spinal cord and nerve roots.…”

Section: Spine Surgerymentioning

confidence: 94%

A Rare Complication of Thoracic Spine Surgery: Pediatric Horner’s Syndrome after Posterior Vertebral Column Resection—A Case Report

2023

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Background: Horner’s syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. It is caused by impairment of a certain pathway in the sympathetic nervous system. It may also appear as part of the clinical signs of other diseases and syndromes, including Pancoast tumors, intradural and/or epidural tumors, thoracic outlet syndrome, syringomyelia, brachial plexus injury, and aortic dissection. Here, we report a very rare complication of vertebral column resection in children, and we present the clinical findings of a case of Horner’s syndrome with a current literature review. Case presentation: A five-year-old child with severe congenital kyphoscoliosis qualified for surgical treatment of the spinal deformity via a posterior approach, with three-column osteotomy and fusion. Results: After successful surgery, the patient presented with HS due to distraction of the sympathetic nerve trunk and, thus, innervation to the left eye. At the 4-year follow-up, the child had fully recovered. Conclusions: Pediatric HS after posterior instrumented scoliosis correction surgery with posterior vertebral column resection of the thoracic spine is very rare. This is the first reported case of HS after posterior vertebral column resection and spinal fusion for congenital kyphoscoliosis without the use of epidural analgesia. Symptom resolution may be variable and, in some cases, delayed.

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Acute Postpartum Horner's Syndrome due to Epidural Anesthesia

Cited by 11 publications

References 5 publications

Horner's Syndrome Secondary to Epidural Anaesthesia Following Posterior Instrumented Scoliosis Correction

Horner's Syndrome Secondary to Epidural Anaesthesia Following Posterior Instrumented Scoliosis Correction

Unusual case of persistent Horner′s syndrome following epidural anaesthesia and caesarean section

A Rare Complication of Thoracic Spine Surgery: Pediatric Horner’s Syndrome after Posterior Vertebral Column Resection—A Case Report

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