The pupillary changes in the Holmes-Adie syndrome.

نویسنده

  • G F RUSSELL
چکیده

Widely varying pupillary abnormalities are in clinical practice often grouped under the heading of the Holmes-Adie syndrome. Adie (1932) described the complete form of the disorder as comprising the typical tonic pupil, with its characteristic delayed reaction to convergence and the loss of some of the tendon reflexes, whereas in the incomplete form he included those cases in which the reflexes were normal, or the pupillary disturbance was atypical (as in the fixed pupil of ophthalmoplegia interna). Alajouanine and Morax (1938) state that no two pupils are identical, and they agree with Lowenstein and Friedman (1942) that between the typical tonic and syphilitic pupils all kinds of intermediary changes may be seen. They suggest, moreover, that pupillotonia is not a fixed condition, but may follow on a paralysed pupil and even precede an Argyll Robertson pupil. A similar evolution in which the fixed pupil of ophthalmoplegia interna becomes typically tonic is described by Rothmann (1903), Axenfeld (1919), Reitsch (1925), and Adie (1932). Adie, on the other hand, says that the tonic pupil may suddenly become dilated and fixed, but there are no definite recorded instances of this. Holmes (1931) describes the course of events in a patient who, over a period of 17 years, developed anisocoria, then a left pupillary lesion, and finally a lesion of the right pupil. In order to unify the many pupillary variants and to understand how the disturbance develops, studies were made of the effect of procaine block of the stellate ganglion and of the reaction of the pupil to drugs. In this way, additional light was shed on the pathogenesis of the lesion.

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عنوان ژورنال:
  • Journal of neurology, neurosurgery, and psychiatry

دوره 19 4  شماره 

صفحات  -

تاریخ انتشار 1956