Adie syndrome
| Adie syndrome | |
|---|---|
| Specialty | Ophthalmology  |
Adie syndrome, sometimes known as Holmes-Adie's syndrome or Adie's Tonic Pupil, is a neurological disorder which affects the pupil of the eye and the autonomic nervous system.[1] It is named after the British neurologist William John Adie. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and characterized by a tonically dilated pupil.[1]
Signs and Symptoms
Adie syndrome presents with three hallmark symptoms, namely at least one abnormally dialiated pupil (mydriasis), loss of deep tendon reflexes and diaphoresis (excessive sweating).[1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.[2]
Causes
Associated with Retinal Detachment surgery, especially when a scleral buckle is used.[3]
Diagnosis
Clinical exam may reveal sectoral paresis of the iris sphincter and/or vermiform iris movements. The tonic pupil may become smaller (miotic) over time which is referred to as "little old Adie's".[4] Testing with low dose (1/8%) pilocarpine may constrict the tonic pupil due to cholinergic denervation supersensitivity.[1] A normal pupil will not constrict with the dilute dose of pilocarpine.[4] CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.[5]
Treatment
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, and should be applied three times daily.[1] Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.[1]
Prognosis
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
It most commonly affects younger women and is unilateral in 80% of cases.[4]
See also
References
- ^ a b c d e f g h i "Holmes-Adie syndrome Information Page". National Institute of Neurological Disorders and Stroke. Retrieved 2008-01-21.
- ^ Stedman's Medical Dictionary, 27th Edition. 2000. ISBN 0-683-40007-X.
{{cite book}}: Cite has empty unknown parameter:|coauthors=(help) - ^ http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2728613
- ^ a b c Haines, Duane E. (2002). Fundamental Neuroscience, 2nd edition. ISBN 0-443-06603-5.
{{cite book}}: Cite has empty unknown parameter:|coauthors=(help) - ^ "Diagnosis of Adie syndrome". WrongDiagnosis.com. Retrieved 2008-01-21.
External links
- Personal experience
- Animation at mrcophth.com
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