Accommodation in the Holmes-Adie Syndrome by G
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.21.4.290 on 1 November 1958. Downloaded from J. Neurol. Neurosurg. Psychiat., 1958, 21, 290. ACCOMMODATION IN THE HOLMES-ADIE SYNDROME BY G. F. M. RUSSELL From the Neurological Research Unit, the National Hospital, Queen Square, London In 1936, Bramwell suggested that the title response to near and far vision respectively. But it "Holmes-Adie syndrome" be given to the clinical has also been noted that the reaction to convergence complex of a slowly reacting pupil and absent tendon may be remarkably wide in its range, considering reflexes in recognition of the descriptions by Holmes that it often follows a stage of complete paralysis (1931) and Adie (1932). Both authors had empha- (Strasburger, 1902). Not only is the reaction to sized the chief clinical features-dilatation of the convergence well preserved when compared to the pupil, apparent loss of the reaction to light, slow reaction to light, but it may in fact be excessive constriction and relaxation in response to near and (Alajouanine and Morax, 1938; Heersema and distant vision, and partial loss of the tendon reflexes. Moersch, 1939). In assessing the degree of tonicity Although the syndrome had been recognized wholly there are, therefore, two criteria: slowness ofguest. Protected by copyright. or in part many years previously (Strasburger, 1902; pupillary movement and preservation of the range Saenger, 1902; Nonne, 1902; Markus, 1906; Weill of movement. and Reys, 1926), credit must go to Adie for stressing Adler and Scheie (1940) showed that the tonic the benign nature of the disorder and distinguishing pupil constricts after the conjunctival instillation it clearly from neurosyphilis.
[Show full text]