Adie syndrome

Adie syndrome

Infobox_Disease
Name = Adie syndrome


Caption =
DiseasesDB = 29742
ICD10 =
ICD9 = ICD9|379.46
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
MeshID = D015845

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.cite web |url=http://www.ninds.nih.gov/disorders/holmes_adie/holmes_adie.htm |title= Holmes-Adie syndrome Information Page | author= |publisher=National Institute of Neurological Disorders and Stroke|accessdate=2008-01-21 |format= |work=] 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.

igns and Symptoms

Adie syndrome presents with three hallmark symptoms, namely abnormal pupil size (mydriasis), loss of deep tendon reflexes and diaphoresis. Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.cite book | last = | first = | authorlink = | coauthors = | title = Stedman's Medical Dictionary, 27th Edition | publisher = | date = 2000 | location = | pages = | url = | doi = | id = | isbn = 0-683-40007-X]

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".cite book | last = Haines | first = Duane E. | authorlink = | coauthors = | title = Fundamental Neuroscience, 2nd edition | publisher = | date = 2002 | location = | pages = | url = | doi = | id = | isbn = 0-443-06603-5] Testing with low dose (1/8%) pilocarpine may constrict the tonic pupil due to cholinergic denervation supersensitivity. A normal pupil will not constrict with the dilute dose of pilocarpine. CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.cite web |url=http://www.wrongdiagnosis.com/a/adie_syndrome/diagnosis.htm |title= Diagnosis of Adie syndrome | author= |publisher= WrongDiagnosis.com|accessdate=2008-01-21 |format= |work=]

Treatment

The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s). Pilocarpine drops may be administered as a treatment as well as a diagnostic measure, and should be applied three times daily. Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.

Prognosis

Adie's syndrome is not life threatening or disabling. As such, there is no mortality rate relating to the condition, however loss of deep tendon reflexes is permanent and may progress over time.

Epidemiology

It most commonly affects younger women and is unilateral in 80% of cases.

References

External links

* [http://oddsnsods.camio.co.uk/node/2 Personal experience]
* [http://www.mrcophth.com/eyeclipartchua/pupils.html Animation] at mrcophth.com


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  • Holmes-Adie syndrome — see Adie s syndrome * * * (hōmzґ aґde) [Sir G.M. Holmes; William John Adie, Australian neurologist in England, 1886–1935] Adie syndrome …   Medical dictionary

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  • Adie's syndrome — Holmes Adie syndrome an abnormality of the pupils of the eyes, often affecting only one eye. The affected pupil is dilated and reacts slowly to light; the response on convergence of the eyes is also slow (see tonic pupil). One or more tendon… …   The new mediacal dictionary

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