Adie's syndrome

Overview said, ankylosing pupil syndrome; Pupil stress disorder. Etiopathologic etiology and pathogenesis is not yet clear. Their lesion may : ① ciliary ganglion neurons and ciliary, or near the lesion; ② on spinal cord lesions; ③ oculomotor nerve lesions. But why this syndrome associated with knee tendon reflexes disappear, so far unknown mechanism. Clinical manifestations occur in the following 30-year-old female. To a pair of knee-length pupil tension tendon reflexes disappear as the main symptoms. Performance of the side Mydriasis, light reaction and adjustment reaction disappeared. But continuing strong light irradiation, there will be more than half a minute to slow Miosis; Rendezvous with five minutes eyes may indicate slow pupil contraction. This phenomenon also said Adie's pupil or the pupil ankylosing. Adie's syndrome to the following classification : (1) fully-pupil tonic stereotypes and knee tendon reflexes disappear. (2) not complete four : 1. Only pupil tonic; 2. Non-stereotyped pupil ankylosis (iris paralysis); 3. knee tendon reflexes disappear stereotypes associated with the non-pupil tonic; 4. Only knee tendon reflexes disappear. Differential diagnosis of Adie's pupil was found in the following diseases : (1) oculomotor nerve palsy (oculomotor paralysis) into complete and incomplete sexual. Complete oculomotor nerve palsy are three characteristics, namely, upper eyelid ptosis flaccid, in the eye outside under oblique, Mydriasis. Light Reaction loss. Often the first to the opposite oculomotor nerve palsy. Protracted oculomotor nerve palsy can cause degeneration, POS Von Grafe's levy. (2) transtentorial hernia (transtentorial hernia) emerge shortly Adi e's pupil suggested tentorial hernia occurred. This was tentorial herniation caused traction and oculomotor nerve compression. Early lateral herniation pupil first narrowing gradually increased. When hooked to bilateral hernia or lower brainstem, as well as the bilateral oculomotor nerve has been the subject of bilateral pupil while there have been dispersed. Mydriasis the first place, and will only emerge extraocular muscle paralysis, eye movement disorders and ptosis. In addition, herniation also often accompanied by disturbance of consciousness, hemiplegia, brain tonic and to the vital signs of change. (3) Other eye injury, glaucoma, congenital syphilis, hysteria, schizophrenia stupor, atropine poisoning can occur so Adie's pupil, and his history of knee tendon reflexes it is not difficult to identify.