Posted on 05/11/2022

What to know about Horner Syndrome

What to know about Horner Syndrome

Horner Syndrome in newborns is called congenital Horner Syndrome and has a lifelong diagnosis. 

We’re going to dive into Horner Syndrome—what it is, the causes, how it’s diagnosed and the treatment. Lastly, I’ll explain how this birth injury can be grounds for a medical malpractice lawsuit against the attending medical provider or hospital team.

If your baby was diagnosed with Horner Syndrome, then chances are they’ll have a permanent disability. 

Read through to learn more about the diagnosis and how to receive a free consultation with a trusted and knowledgable medical malpractice attorney who has experience fighting birth injury lawsuits.

What is Horner syndrome?

Over 1600 babies are affected by Horner Syndrome. 

Horner syndrome is when the brain lacks control over the newborns visual functions due to nerve damage. 

There are tons of nerves lining the face which receive signals from the brain, in an effort to control the eye.

Horner syndrome occurs when there is damage to the nerve system on either side of the face, which disrupts the normal communication between the brain and the facial nerves. 

Roughly 5% of cases are congenital. Because this condition occurs at birth, it is considered a birth injury. 

There are a few common and primary symptoms of Horner Syndrome, including:

  • Miosis, which is when the pupils (the inner black “hole” of the eyes) remain constricted, or small
  • Anisocoria, which is when there are differentiating pupil sizes
  • Ptosis, which is when of the the upper eyelids droops
  • Anhidrosis, which is when the affecting side appears to not sweat
  • Lighter pigmentation, which is when the affecting eye appears lighter in color than the other

Causes of Horner Syndrome

The leading cause of congenital Horner syndrome is physical trauma to a baby’s face. Physical trauma typically occurs during labor, however this can also happen before or after labor.

Facial damage is highly likely during a vaginal birth. In an effort to reduce any possibility of a birth injury, it is imperative for your obstetrician to act carefully and quickly.

It is also critical that your obstetrician has a prenatal plan in place, in case of a complicated labor.

Two common tools used to assist a complicated labor are forceps and a vacuum extractor. Both instruments work to help pull the newborn out of the birth canal.

Sometimes while using either instrument, the obstetrician will apply too much force or pressure, which can cause injuries to your baby.

Forceps are a type of medical instrument that look almost like tongs. Forceps are designed to fit the heads of babies to help gently pull the newborn through the birth canal.

Vacuum extractors are a type of suction-instrument. The vacuum extractors attach to your baby’s head and help navigate them through the birth canal.

Both methods are commonly used, however, errors and problems can still arise.

Is it possible that your child suffered an accident during labor? If so, meet with a medical malpractice attorney to determine if it was due to malpractice.

Diagnosis of Horner Syndrome

Typically, it’s difficult to identify and diagnose symptoms of Horner Syndrome. 

The diagnosis will generally happen from a physical examination by the pediatrician. 

If there is any suspicion of Horner Syndrome, the medical provider may use specific eye drops to dilate the baby’s pupils and then gauge how the pupils respond to light to confirm a diagnosis.

The eye on the affected side of the body will often be less reactive to the than the unaffected eye. 

Medical providers can also confirm a diagnosis with an MRI, CT scans and ultrasounds of the carotid artery. Both tests should be ordered to see if there is any damage to the facial nerves or carotid artery.

With congenital Horner Syndrome, studies have shown the biggest indicator of a diagnosis is the event of a traumatic birth.

A traumatic birth can happen for multiple reasons. 

Some common reasons why mothers have a complicated deliver can be due to having a large gestational weight, weakened contractions, or a small birth canal.

Sometimes traumatic births occur due to complications which arise during labor, such as shoulder dystocia or perinatal asphyxia. 

These complications require your obstetrician to act immediately and efficiently in an attempt to reduce further risks.


Treatment for Horner Syndrome is largely dependent upon the underlying cause which triggers the diagnosis. 

While there is currently no treatment specifically for congenital Horner Syndrome, this means there is a possibility to restore the nerve damage. 

Congenital Horner Syndrome treatment, however, is much more limited as the underlying cause is a traumatic birth.

Therapy and treatment may be necessary as the child continues to grow and can differ depending on the type of damage.

While there is a possibility of strengthening, or restoring, the neural damage—congenital Horner Syndrome is most likely a permanent diagnosis.

Horner Syndrome and Medical Negligence

Horner Syndrome is considered a birth injury and falls under malpractice if the injury occured due to medical malpractice or negligence.

Medical malpractice and negligence is when the medical provider, or hospital personnel, do not provide the standard level of care which further results in an injury to their patient.

With Horner Syndrome, medical malpractice can occur in several different forms.

This can include, but is not limited to:

  • Not having a prenatal plan 
  • Miscommunication between obstetrician and health care team
  • Errors in the use of forceps or a vacuum extractor
  • Not recognizing signs and symptoms of a difficult labor, or not acting quickly and efficiently in the event of an unexpected, complicated delivery

If your newborn was diagnosed with Horner Syndrome and you believe this birth injury occured due to malpractice, then you must speak with an experienced medical malpractice attorney.

They will review all of the facts of your claim and any evidence to determine if you can file a lawsuit. 

Call the attorneys at Grover Lewis Johnson for the best legal advice on birth injuries. 

They have been fighting medical malpractice in Michigan for the last 25 years and know exactly what is required to win.

They don’t expect any payments for their legal services until they’ve won your case – and if they don’t win, they don’t get paid.

Fill out their intake form to discuss your case with one of their attorneys, at no-cost to you.