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16-September-2008 16:15:15 - Adie syndrome Adie syndrome Classification and external resources ICD-9 379.46 DiseasesDB 29742 MeSH 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.1 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 Contents 1 Signs and Symptoms 2 Diagnosis 3 Treatment 4 Prognosis 5 Epidemiology 6 References 7 External links Signs and Symptoms This photograph shows an abnormally sized pupil which has been dilated with eye drops This photograph shows an abnormally sized pupil which has been dilated with eye drops Adie syndrome presents with three hallmark symptoms, namely abnormal pupil size mydriasis, loss of deep tendon reflexes and diaphoresis.1 Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.2 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.3 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.3 CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.4 Treatment The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eyes.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.3 References ^ a b c d e f g h i Holmes-Adie syndrome Information Page. National Institute of Neurological Disorders and Stroke. Retrieved on 2008-01-21. ^ 2000 Stedman's Medical Dictionary, 27th ion. ISBN 0-683-40007-X. ^ a b c Haines, Duane E. 2002. Fundamental Neuroscience, 2nd ion. ISBN 0-443-06603-5. ^ Diagnosis of Adie syndrome. WrongDiagnosis.com. Retrieved on 2008-01-21. External links Personal experience Animation at mrcophth.com v d e Eye disease - pathology of the eye H00-H59, 360-379 Adnexa eyelid: inflammation Stye, Chalazion, Blepharitis - Entropion - Ectropion - Lagophthalmos - Blepharochalasis - Ptosis - Blepharophimosis - Xanthelasma - Trichiasis lacrimal system: Dacryoadenitis - Epiphora - Dacryocystitis orbit: Exophthalmos - Enophthalmos Eyeball Conjunctiva Conjunctivitis Allergic conjunctivitis - Pterygium - Pinguecula - Subconjunctival hemorrhage Fibrous tunic sclera: Scleritis cornea: Keratitis - Corneal ulcer - Snow blindness - Thygeson's superficial punctate keratopathy - Fuchs' dystrophy - Keratoconus - Keratoconjunctivitis sicca - Arc eye - Keratoconjunctivitis - Corneal neovascularization - Kayser-Fleischer ring - Arcus senilis - Band keratopathy Iris and ciliary body Iritis - Uveitis - Iridocyclitis - Hyphema - Persistent pupillary membrane - Iridodialysis - Synechia Lens Cataract - Aphakia - Ectopia lentis Choroid Choroideremia - Choroiditis Chorioretinitis Retina Retinitis Chorioretinitis - Retinal detachment - Retinoschisis - Retinopathy Bietti's crystalline dystrophy, Coats disease, Diabetic retinopathy, Hypertensive retinopathy, Retinopathy of prematurity - Macular degeneration - Retinitis pigmentosa - Retinal haemorrhage - Central serous retinopathy - Macular edema - Epiretinal membrane - Macular pucker - Vitelliform macular dystrophy - Leber's congenital amaurosis - Birdshot chorioretinopathy Optic nerve and visual pathways Optic neuritis - Papilledema - Optic atrophy - Leber's herary optic neuropathy - Dominant optic atrophy - Optic disc drusen - Glaucoma - Toxic and nutritional optic neuropathy - Anterior ischemic optic neuropathy Ocular muscles, binocular movement, accommodation and refraction Paralytic strabismus: Ophthalmoparesis - Progressive external ophthalmoplegia - Palsy III, IV, VI - Kearns-Sayre syndrome Other strabismus: Esotropia/Exotropia - Hypertropia - Heterophoria Esophoria, Exophoria - Brown's syndrome - Duane syndrome Other binocular: Conjugate gaze palsy - Convergence insufficiency - Internuclear ophthalmoplegia - One and a half syndrome Refractive error: Hyperopia/Myopia - Astigmatism - Anisometropia/Aniseikonia - Presbyopia Visual disturbances and blindness Amblyopia - Leber's congenital amaurosis - Subjective Asthenopia, Hemeralopia, Photophobia, Scintillating scotoma - Diplopia - Scotoma - Anopsia Binasal hemianopsia, Bitemporal hemianopsia, Homonymous hemianopsia, Quadrantanopia - Color blindness Achromatopsia, Dichromacy, Monochromacy - Nyctalopia Oguchi disease - Blindness/Low vision Pupil Anisocoria - Argyll Robertson pupil - Marcus Gunn pupil/Marcus Gunn phenomenon - Adie syndrome - Miosis - Mydriasis - Cycloplegia Infectious diseases Trachoma - Onchocerciasis Other Nystagmus - Glaucoma/Ocular hypertension - Floater - Leber's herary optic neuropathy - Red eye - Keratomycosis - Xerophthalmia - Phthisis bulbi See also congenital This neuroscience article is a stub. Retrieved from http://en..org/wiki/Adie_syndrome Categories: Neurological disorders | Anatomical pathology | Syndromes | Neuroscience stubs Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Español Bahasa Indonesia Italiano Nederlands Norsk nynorsk Português This page was last modified on 11 July 2008, at 22:16
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