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Newborn and Infant Care

Torticollis/Horner`s/Development

11/12/2003

Question:

My infant is 9 weeks old. She is being treated by a P.T. for Torticollis and was just dx as having Horner`s Syndrome. She is otherwise an alert, normal baby already reaching out for mobiles, etc. At the last visit to the pediatrician (before he referred me to an Opthalmologist re: Horner`s), the baby`s weight and height had improved from the 25th percentile to the 75th; however, the head circumference was still at the 25th. I am a nursing mother if that makes any difference.

My questions are for any information or thoughts you may have regarding the **head circumference** and any relationships between the syndromes.

Lastly and of concern -- is it possible that if the Torticollis is addressed aggressively and eliminated that the Horner`s syndrome **could disappear** by virtue of that, or just thru time as she develops (i.e. is it reversible in any cases).

Thank you ever so much for your kind input on these issues. Thanks again! P. S. I understand there is a torticollis center in N.Y. - would it be worth visiting since we caught her so early (2 wks)?

Answer:

I could not find any information concerning a relationship between the syndromes and head circumference. Most of this type of problem occurs in babies who are large and that does not appear to be the case in this situation. Most infants with torticollis recover within 2 to 3 months. If the baby requires surgery for correction, most references state it is better to have the surgery sooner versus later. They do state that the facial asymmetry should disappear if the surgery is done. Resolution of the signs of Horner`s Syndrome is dependent upon whether the injury to the nerve is temporary or permanent. I would certainly contact the torticollis center in NY. Early treatment is beneficial and they may have something additional to offer. Good Luck.

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Response by:

Tina   Weitkamp, RNC, MSN Tina Weitkamp, RNC, MSN
Associate Professor of Clinical Nursing
College of Nursing
University of Cincinnati