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Show Poster 285 Likelihood of diagnosing neuroblastoma in isolated Horner syndrome Nitza Goldenberg-Cohen1, Avi Ben Shabat2, Shifra Ash3 Bnai Zion Medical Center, Haifa, Haifa, Israel, 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, 3Pediatric Oncology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel 1 Introduction: To evaluate whether isolated Horner syndrome in children leads to a diagnosis of neuroblastoma (NB), and the incidence of NB in children diagnosed with anisocoria Methods: Review of the files of 125 children investigated for anisocoria between the years 2007-2015. Of them, 48 children had a positive cocaine test for Horner syndrome, 34 of them younger than 1 year old. Twelve were excluded because of lack of data. Complete evaluation included MRI of the brain and neck, abdominal ultrasound, and urine catecholamines. Data of follow up period and management were summarized. In addition, files of 173 children diagnosed with NB were reviewed for the existence of Horner's syndrome at presentation. Results: None of the 22 patients diagnosed with Horner syndrome had NB. Complete investigation was performed in 14 (64%) patients, partial investigation in 6 (27%) and observation only in 2 (9%). The leading etiology was idiopathic, followed by birth trauma and post-surgical. Of the 173 children diagnosed with NB, 5 (3%) had Horner syndrome detected after the diagnosis of NB was made, 4 of them post-surgical intervention. The remaining child was diagnosed due to the tumor symptoms and signs and the anisocoria was missed until a later stage. Conclusions: None of the children evaluated for Horner syndrome had NB, and none of the children with NB were diagnosed due to anisocoria. Even when Horner syndrome was noted, it was after NB diagnosis was made. These findings may suggest that anisocoria is not indicative of NB and investigation can be limited to abdominal ultrasound and urine catecholamines, whereas full investigation can be reserved for highly suspicious cases with other signs or symptoms of NB. References: None. Keywords: Pediatric neuro-ophthalmology, Pupils Retina, Tumors, Diagnostic Tests (ERG, VER, OCT, HRT, mfERG, etc) Eyelid & adnexal disease, Neuro-ophth & systyemic disease ( eg. MS, MG, thyroid) Financial Disclosures: The authors had no disclosures. Grant Support: This study was partially supported by the Zanvyl and Isabelle Krieger Fund, Baltimore, Maryland, USA. 440 | North American Neuro-Ophthalmology Society |
