Baby Diagnosed with Pediatric Cervical Sympathetic Paralysis Syndrome Shows Improvement After One Week of Home Care

In this case report, a 10-month-old male infant was diagnosed with pediatric cervical sympathetic paralysis syndrome following a mild viral infection. The child's mother reported that the baby had been exposed to cold weather two days prior, which led to a low-grade fever. After physical cooling methods were applied, the fever subsided. However, over the next two days, the mother noticed facial asymmetry with localized flushing and uneven eye size. Upon examination, the infant was diagnosed with cervical sympathetic paralysis. Given the likely viral etiology, the treatment plan included home-based care with warm compresses and gentle massage. One week later, the child showed significant improvement with symmetric eye size and reduced facial flushing.

Patient Overview

Age and Gender: 10-month-old maleDiagnosis: Pediatric Cervical Sympathetic Paralysis SyndromeHospital: Shanghai Sixth People's HospitalVisit Date: November 2021Treatment Approach: Conservative home care with warm compresses and massageFollow-up Duration: One weekOutcome: Symptom resolution with restored facial symmetry and normal eye size

Initial Presentation

A concerned mother brought her 10-month-old son to the clinic after noticing sudden facial asymmetry. She reported that the right eye appeared smaller than the left, and the left side of the baby's face was flushed. The child remained active, with no changes in appetite or behavior. Upon further inquiry, the mother revealed the infant had a mild fever (37.9°C) two days earlier, accompanied by nasal congestion, likely due to cold exposure. Physical cooling brought the temperature down without the use of medication. Based on the clinical presentation and recent viral symptoms, a diagnosis of pediatric cervical sympathetic paralysis syndrome was made.

Treatment Plan

Home-Based Care Strategy

Given the infant's previously healthy status and absence of chronic conditions, the condition was interpreted as a post-viral, self-limiting neurological response. No pharmacological intervention was deemed necessary. Instead, the family was advised to apply warm compresses and perform gentle facial massages to promote circulation and nerve function. Additionally, the child was instructed to rest at home, avoid exposure to cold winds, and stay away from crowded places to prevent reinfection. A follow-up appointment was scheduled for one week later.

Follow-Up and Recovery

At the one-week follow-up, the infant exhibited complete resolution of symptoms. Facial flushing had diminished, and both eyes were now symmetric in size. The child's energy levels, appetite, sleep, and overall behavior were normal, confirming a full recovery. This outcome supported the initial hypothesis that the condition was a transient neurological complication of a mild viral infection.

Recommendations for Parents

While the infant recovered well without medication, it's important to note that young babies have underdeveloped immune systems. Parents should remain vigilant, especially during peak viral seasons such as winter and spring. Keeping the child warm, avoiding crowded areas, and shielding from cold drafts can help prevent future episodes. If symptoms recur or worsen, prompt consultation with a pediatric neurologist is recommended.

Clinical Insights and Final Thoughts

Paediatric cervical sympathetic paralysis syndrome typically presents with ptosis, miosis, and facial flushing on the affected side. Causes can include infection, trauma, inflammation, or vascular issues. In this case, the condition was a transient consequence of a mild upper respiratory infection. It highlights the importance of parental awareness and early recognition of subtle neurological signs in infants. As young children are particularly vulnerable to environmental pathogens, timely intervention and close monitoring are essential to ensure a positive outcome.