Horner’s Syndrome as Complication of Extracorporeal Membrane Oxygenation in a Neonate

A term-born baby girl had a perinatal course complicated by meconium aspiration syndrome, pulmonary hemorrhage, and shock. She was placed on extracorporeal membrane oxygenation (ECMO) on day of life 3 after high-frequency ventilation failed to maintain adequate oxygenation. She was taken off ECMO on day of life 13, and neurology was consulted for facial asymmetry at 3 weeks of age (Figure 1). She had partial ptosis of the right eye with miosis (right pupil 2 mm less than left, both reactive to light); extraocular movements were normal. Her face appeared symmetric, and she had normal tone, strength, and reflexes.

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• Figure 1 

  Photograph showing right-sided partial ptosis. Miosis is not well appreciated because of a dark iris.