Presentation
Patients present with the pupil of one eye being larger and only slowly constricts in bright light (tonic pupil). There is also absence of deep tendon reflexes, usually the Achilles tendon. Mike Cadogan December 5, 2018 [litfl.com]
Ciliary muscle dysfunction may also present with symptoms of blurry vision both for near and far vision and during transitions and anisocoria. [eyewiki.aao.org]
Acronym ADIEP Synonyms Adie syndrome Holmes-Adie syndrome Tonic pupil Disclaimer Any medical or genetic information present in this entry is provided for research, educational and informational purposes only. [uniprot.org]
Patients most commonly present with a classic triad of: diaphoresis absent deep tendon reflexes, e.g. ankle jerk an Adie pupil : tonically dilated and responds poorly or not at all to light Unilateral pupillary symptoms are more common than bilateral [radiopaedia.org]
It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit? does not give medical advice. [whonamedit.com]
Entire Body System
- Epilepsy
In patients with refractory epilepsy fitted with vagal nerve stimulators, a proportion experienced coughing corresponding to the stimulator “on” period. 18 A therapeutic trial of anticholinergic agents, as in patient 2, may help to determine the vagal [jnnp.bmj.com]
- Asymptomatic
Asymptomatic autonomic and sweat dysfunction in patients with Adie’s syndrome. J Neuroophthalmol. 1998;18(2):143-47. http://www.ncbi.nlm.nih.gov/pubmed/9621272 INTERNET Lee AG. Tonic Pupil. UpToDate, Inc.June 19, 2018. [rarediseases.org]
Gastrointestinal
- Nausea
Among milk consumer’s respondents, 12.8% (24/188) reported episodes of symptoms including diarrhea (19/37), fever (5/37), bloating stomach (4/37), vomiting (3/37) and nausea (1/37). [cgspace.cgiar.org]
- Vomiting
Among milk consumer’s respondents, 12.8% (24/188) reported episodes of symptoms including diarrhea (19/37), fever (5/37), bloating stomach (4/37), vomiting (3/37) and nausea (1/37). [cgspace.cgiar.org]
Eyes
- Anisocoria
The difference in pupil size (anisocoria) can be found in a variety of ophthalmic disorders, which may be benign or not, such as physiological anisocoria, Horner’s syndrome, Adie’s pupil, pharmacological anisocoria, pupillary supranuclear disorders, problems [scielo.br]
Ciliary muscle dysfunction may also present with symptoms of blurry vision both for near and far vision and during transitions and anisocoria. [eyewiki.aao.org]
Anisocoria, Physiologic (Anisocoria) Anisometropia Anisometropic Amblyopia (Amblyopia) Anophthalmia (Anophthalmos) Anophthalmos Anterior Ischemic Optic Neuropathy (Optic Neuropathy, Ischemic) Anterior Uveitides (Uveitis, Anterior) Anton Syndrome (Blindness [provisu.ch]
Six years earlier, anisocoria of the left eye had developed that was diagnosed as tonic, or Adie's, pupil. On examination, she had a left-sided tonic pupil with light–near dissociation and a positive pilocarpine test. [nejm.org]
[…] a G 2017 4 Anisocoria after anesthesia induction caused by Adie syndrome. ( 25138821 ) Ishihara M...Takahashi K 2015 5 A Rare Case in the Emergency Department: Holmes-Adie Syndrome. ( 27437522 ) Colak S...Akdemir HU 2015 6 Complete Vogt-Koyanagi-Harada [malacards.org]
Skin
- Anhidrosis
Tonic pupil, areflexia, and segmental anhidrosis: two additional cases of Ross syndrome and review of the literature Michael Weller, Helmut Wilhelm, Norbert Sommer, Johannes Dichgans, Horst Wiethölter Journal of Neurology 1992 Related Papers [semanticscholar.org]
Neurologic
- Areflexia
Purpose - To evaluate ankle areflexia in Holmes-Adie syndrome (HAS). [moh-it.pure.elsevier.com]
All our patients had typical ocular findings and tendon areflexia indicative of Holmes-Adie syndrome. [jnnp.bmj.com]
Pilocarpine test. ( 29196034 ) 2018 2 Adie Pupil as the Initial Presentation of Localized En Coup de Sabre Scleroderma. ( 28668815 ) Laxer RM...Pope E 2017 3 Areflexia in Holmes-Adie syndrome: A sign in search of its pathophysiology. ( 28939242 ) Esta [malacards.org]
Tonic pupil, areflexia, and segmental anhidrosis: two additional cases of Ross syndrome and review of the literature Michael Weller, Helmut Wilhelm, Norbert Sommer, Johannes Dichgans, Horst Wiethölter Journal of Neurology 1992 Related Papers [semanticscholar.org]
Neurophysiological evaluation of areflexia in Holmes-Adie syndrome. Neurophysiol Clin. 1999;29(3):255-62. http://www.ncbi.nlm.nih.gov/pubmed/10431290 Jacobson DM, Vierkant RA. [rarediseases.org]
- Headache
She abandoned treatment after developing headache as a side effect of the drug. Personal background reports thalassemia minor, flu shot one year ago and infection treatment of H. pylori for 6 months. She is a folic acid user. [scielo.br]
Headache, facial pain, or emotional fluctuations may occur in some patients. The disorder does not ordinarily cause severe disability. Adie syndrome usually affects the pupil of one eye, although the other eye may eventually become affected as well. [rarediseases.org]
On presentation at the age of 26 she had a 2 year history of posture induced syncope together with paroxysmal throbbing headaches and epistaxis provoked by prolonged recumbency. [jnnp.bmj.com]
- Dysautonomia
Intracranial hemorrhage/stroke with third nerve palsy Varicella-zoster infection (ophthalmic branch of trigeminal nerve) Syphilis (Argyll Robertson pupil, generally bilateral, small, brisk redilation) Miller Fisher syndrome Charcot Marie Tooth disease Systemic dysautonomia [eyewiki.aao.org]
- Vertigo
She reported associated vertigo. She searched for neurological aid and a MRI of the brain was performed without changes. [scielo.br]
Treatment
Thoracic sympathectomy, which severs the involved sympathetic nerve, is the definitive treatment for excessive sweating. × Treatment Doctors may prescribe reading glasses to compensate for impaired vision in the affected eye, and pilocarpine drops to [ninds.nih.gov]
[ edit ] The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s). [1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure. [1] Thoracic sympathectomy [en.wikipedia.org]
Treatment Doctors may prescribe reading glasses to compensate for impaired vision in the affected eye, and pilocarpine drops to be applied 3 times daily to constrict the dilated pupil. [brainfacts.org]
Although bronchodilator treatment improved the dyspnoea it did not prevent coughing. She had been hypertensive and noted that treatment with an angiotensin converting enzyme inhibitor exacerbated her cough and the drug was withdrawn. [jnnp.bmj.com]
She went to the otorhinolaryngologist, where she was diagnosed with Meniere’s Syndrome, and she began treatment with Labirin® (betahistine dihydrochloride). She abandoned treatment after developing headache as a side effect of the drug. [scielo.br]
Prognosis
Prognosis Holmes-Adie syndrome is not life-threatening or disabling. The loss of deep tendon reflexes is permanent. Some symptoms of the disorder may progress. [ninds.nih.gov]
This valuable tool offers detailed descriptions, facts on treatment and prognosis, and patient organization contact information for over 500 identified neurological disorders. Neurological Disorders and Stroke » [brainfacts.org]
[…] correct for impairment of the eye(s). [1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure. [1] Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy. [1] Prognosis [en.wikipedia.org]
[…] alcoholism Multiple sclerosis Herpes zoster Neurosarcoidosis When considering these additional potential diagnoses, it may be valuable to obtain syphilis serologies and check for history of diabetes, trauma, neurologic diseases Management Treatment and Prognosis [eyewiki.aao.org]
Etiology
It is thought to result form damage to the ciliary ganglion and the dorsal root ganglion by viral or bacterial infections, however there are idiopathic etiologies 1,3. [radiopaedia.org]
The etiology is still unknown. Bibliography J. Ware: Observations relative to the near and distant sight of different persons. Philosophical Transactions of the Royal Society of London, 1813: 31-50. [whonamedit.com]
Epidemiology
[…] treatable by drug therapy. [1] Prognosis [ edit ] Adie's syndrome is not life-threatening or disabling. [1] As such, there is no mortality rate relating to the condition; however, loss of deep tendon reflexes is permanent and may progress over time. [1] Epidemiology [en.wikipedia.org]
However, it may be noted that the tonic pupil was initially described in 1931 nearly synchronously by Adie, Morgan, Symonds, and Holmes in (2-4)[2] [3] [4] Epidemiology Adie tonic pupil has a prevalence of 2 per 1000 population and occurs in a 2.6:1 female [eyewiki.aao.org]
Pathophysiology
[…] loss of deep tendon reflexes, and abnormalities of sweating. [1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading. [3] Some individual with Adie syndrome may also have cardiovascular abnormalities. [4] Pathophysiology [en.wikipedia.org]
Pilocarpine test. ( 29196034 ) 2018 2 Adie Pupil as the Initial Presentation of Localized En Coup de Sabre Scleroderma. ( 28668815 ) Laxer RM...Pope E 2017 3 Areflexia in Holmes-Adie syndrome: A sign in search of its pathophysiology. ( 28939242 ) Esta [malacards.org]
Prevention
Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders, such as HAS. View research on this topic. View studies being conducted about this condition. View NINDS publications on this topic. [brainfacts.org]
Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders, such as HAS. Information from the National Library of Medicine’s MedlinePlus Autonomic Nervous System Disorders Eye Diseases [ninds.nih.gov]
Although bronchodilator treatment improved the dyspnoea it did not prevent coughing. She had been hypertensive and noted that treatment with an angiotensin converting enzyme inhibitor exacerbated her cough and the drug was withdrawn. [jnnp.bmj.com]