1/3. Segmental facial anhidrosis and tonic pupils with preserved deep tendon reflexes: a novel autonomic neuropathy.A 31-year-old woman had exertional right-sided hemifacial flushing and sweating. Examination demonstrated slightly dilated pupils with absent constriction to light and a tonic near response and redilatation, features consistent with adie syndrome. Neurological examination was otherwise normal, including preservation of deep tendon reflexes. magnetic resonance imaging of brain and spine were normal. The combination of unilateral loss of sudomotor and vasomotor activity without loss of ocular sympathetic innervation fulfills the diagnosis of Harlequin syndrome. The combination of Harlequin and Adie syndromes has been called Ross syndrome, but the preservation of deep tendon reflexes precludes a diagnosis of Ross syndrome in our patient. This previously undescribed variant adds further complexity to the spectrum of autonomic neuropathies.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/3. Spontaneous cyclic segmental sphincter spasms in an Adie's tonic pupil.A 43-year-old woman with bilateral Adie's tonic pupils had a segment of one iris sphincter that contracted spontaneously every few seconds, but was not influenced by light, near vision, or eye movements.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/3. Chronic cough in the Holmes-adie syndrome: association in five cases with autonomic dysfunction.The Holmes-adie syndrome consists of unilateral or bilateral tonic pupils with near light dissociation and tendon areflexia. It is associated with autonomic disturbances affecting sudomotor and vasomotor function. Five such patients are reported on who also had a troublesome chronic dry cough, which was of unknown aetiology and was resistant to a range of treatments. The cough may be related to involvement of afferent or efferent pathways in the vagus. Chronic cough may be an accompaniment in the Holmes-adie syndrome, like other forms of autonomic dysfunction.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |