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Revista de Neurologia
Topics: Adult; Chronic Disease; Female; Humans; Hypertension; Kidney Failure, Chronic; Kidney Transplantation; Postoperative Complications; Renal Dialysis; Reoperation; Tonic Pupil
PubMed: 19173212
DOI: No ID Found -
Journal of Neurology, Neurosurgery, and... Oct 1971Two patients who presented with symptoms due to orthostatic hypotension were found on examination to have the Holmes-Adie syndrome. Physiological investigation suggested...
Two patients who presented with symptoms due to orthostatic hypotension were found on examination to have the Holmes-Adie syndrome. Physiological investigation suggested that they both had an afferent block from baroreceptors in contrast to the efferent autonomic block found in most other cases of idiopathic orthostatic hypotension, including the cases of multisystem disease, now often called the Shy-Drager syndrome.
Topics: Adie Syndrome; Adult; Autonomic Nervous System; Blood Pressure; Dysautonomia, Familial; Electromyography; Female; Heart Rate; Humans; Hypotension, Orthostatic; Male; Middle Aged; Neural Conduction; Neurons, Afferent; Posture; Pressoreceptors; Valsalva Maneuver
PubMed: 5122384
DOI: 10.1136/jnnp.34.5.562 -
Journal of Clinical Neurology (Seoul,... Mar 2010While tonic pupils have been attributed to various diseases, including syphilis, herpes zoster, orbital trauma, temporal arteritis, endometriosis, and paraneoplastic...
BACKGROUND
While tonic pupils have been attributed to various diseases, including syphilis, herpes zoster, orbital trauma, temporal arteritis, endometriosis, and paraneoplastic syndromes, obstructive hydrocephalus has not been implicated.
CASE REPORT
A 36-year-old woman visited a neurology department with a 7-day history of throbbing headache and blurred vision in both eyes. She had early dorsal midbrain syndrome mimicking an Adie's tonic pupil, and cholinergic supersensitivity was demonstrated using topical 0.125% pilocarpine. Brain MRI revealed obstructive hydrocephalus at the level of the aqueduct of Sylvius, and her symptoms resolved 4 days after surgery.
CONCLUSIONS
We report a patient with early dorsal midbrain syndrome that was initially believed to represent a tonic pupil on the basis of pharmacologic testing. The findings in our patient suggested that early dorsal midbrain syndrome mimicking an Adie's tonic pupil can be caused by obstructive hydrocephalus compressing the Edinger-Westphal nucleus.
PubMed: 20386642
DOI: 10.3988/jcn.2010.6.1.38 -
JAMA Surgery Jul 2022Distal radius fractures are common and are managed with or without surgery. Current evidence indicates surgical treatment is not superior to nonsurgical treatment at 12... (Observational Study)
Observational Study Randomized Controlled Trial
IMPORTANCE
Distal radius fractures are common and are managed with or without surgery. Current evidence indicates surgical treatment is not superior to nonsurgical treatment at 12 months.
OBJECTIVE
Does surgical treatment for displaced distal radius fractures in patients 60 years or older provide better patient-reported wrist pain and function outcomes than nonsurgical treatment at 24 months?
DESIGN, SETTING, AND PARTICIPANTS
In this secondary analysis of a combined multicenter randomized clinical trial (RCT) and a parallel observational study, 300 patients were screened from 19 centers in Australia and New Zealand. Of these, 166 participants were randomized to surgical or nonsurgical treatment. Participants who declined randomization (n = 134) were included in the parallel observational group with the same treatment options and follow-up. Participants were followed up at 3, 12, and 24 months by a blinded assessor. The 24-month outcomes are reported herein. Data were collected from December 1, 2016, to December 31, 2020, and analyzed from February 4 to October 21, 2021.
INTERVENTIONS
Surgical treatment consisting of open reduction and internal fixation using a volar-locking plate (VLP group) and nonsurgical treatment consisting of closed reduction and cast immobilization (CR group).
MAIN OUTCOMES AND MEASURES
The primary outcome was patient-reported function using the Patient-Rated Wrist Evaluation (PRWE) questionnaire. Secondary outcomes included health-related quality of life, wrist pain, patient-reported treatment success, patient-rated bother with appearance, and posttreatment complications.
RESULTS
Among the 166 randomized and 134 observational participants (300 participants; mean [SD] age, 71.2 [7.5] years; 269 women [89.7%]), 151 (91.0%) randomized and 118 (88.1%) observational participants were followed up at 24 months. In the RCT, no clinically important difference occurred in mean PRWE scores at 24 months (13.6 [95% CI, 9.1-18.1] points for VLP fixation vs 15.8 [95% CI, 11.3-20.2] points for CR; mean difference, 2.1 [95% CI, -4.2 to 8.5]; P = .50). There were no between-group differences in all other outcomes except for patient-reported treatment success, which favored VLP fixation (33 of 74 [44.6%] in the CR group vs 54 of 72 [75.0%] in the VLP fixation group reported very successful treatment; P = .002). Rates of posttreatment complications were generally low and similar between treatment groups, including deep infection (1 of 76 [1.3%] in the CR group vs 0 of 75 in the VLP fixation group) and complex regional pain syndrome (2 of 76 [2.6%] in the CR group vs 1 of 75 [1.3%] in the VLP fixation group). The 24-month trial outcomes were consistent with 12-month outcomes and with outcomes from the observational group.
CONCLUSIONS AND RELEVANCE
Consistent with previous reports, these findings suggest that VLP fixation may not be superior to CR for displaced distal radius fractures for patient-rated wrist function in persons 60 years or older during a 2-year period. Significantly higher patient-reported treatment success at 2 years in the VLP group may be attributable to other treatment outcomes not captured in this study.
TRIAL REGISTRATION
ANZCTR.org Identifier: ACTRN12616000969460.
Topics: Aged; Bone Plates; Female; Fracture Fixation, Internal; Humans; Pain; Radius; Radius Fractures; Treatment Outcome
PubMed: 35476128
DOI: 10.1001/jamasurg.2022.0809 -
Acta Neurologica Taiwanica Sep 2023Ross syndrome is a rare disorder of unknown etiology, characterized by the triad of segmental anhidrosis, tonic pupil, and areflexia/hyporeflexia. Ross syndrome is...
Ross syndrome is a rare disorder of unknown etiology, characterized by the triad of segmental anhidrosis, tonic pupil, and areflexia/hyporeflexia. Ross syndrome is thought to be a limited and selective ganglioneuropathy. Its etiology has not been fully elucidated. Autonomic findings may also accompany. We wanted to present our 25-year-old patient who was diagnosed with Ross syndrome and presented with complaints of inability to sweat, heat intolerance, headache, diarrhea and chronic cough. Keyword: cough, tonic pupil, anhidrosis, compensatory.
Topics: Humans; Adult; Tonic Pupil; Hypohidrosis; Cough; Pupil Disorders; Adie Syndrome; Reflex, Abnormal
PubMed: 37674425
DOI: No ID Found -
Journal of Neurology, Neurosurgery, and... Nov 1958
Topics: Accommodation, Ocular; Adie Syndrome; Eye; Head; Humans; Muscles
PubMed: 13611571
DOI: 10.1136/jnnp.21.4.290 -
Acta Bio-medica : Atenei Parmensis Nov 2021The literature describes that the renowned artwork of the genius of human anatomy, Leonardo da Vinci (1452-1519), known as Mona Lisa (1503-1506), is among one of the...
The literature describes that the renowned artwork of the genius of human anatomy, Leonardo da Vinci (1452-1519), known as Mona Lisa (1503-1506), is among one of the most enigmatic artworks in the History of Art. In this context, many details inserted on the composition of this artwork, including those related to Mona Lisa physical aspects' (anatomy) are controversial. The few known descriptions that provide some thorough indications about the woman who served as the model for this work, were written by Giorgio Vasari (1511-1574) in 1550. According to Vasari, the Mona Lisa is a portrait of Lisa del Giocondo (1479-1542) and although he has given a detailed description concerning Lisa's physical characteristics, some are not fully understood so far. In this context, the unequal size of her pupils stands out, a clinical condition known as anisocoria. On this detail, this Letter presents unprecedented pieces of evidence that the anisocoria represented in Mona Lisa may be an indicator that Lisa del Giocondo had a neurological disorder known as Holmes-Adie Syndrome, which could have been caused by an endocrine disruption of the thyroid hormones. Thus, the pieces of information presented on this Letter are essential for further studies once, through them, it is possible to know more about the physical characteristics and also about the probable health condition of the renowned character of one of the most famous artworks of history.
Topics: Adie Syndrome; Famous Persons; Female; Humans; Male
PubMed: 34738587
DOI: 10.23750/abm.v92i5.10355 -
World Journal of Gastroenterology Mar 2006A 35-year-old female patient presented with the following symptoms of Holmes-Adie syndrome: photophobia,enlargement of the left pupil unresponsive to light, Achilles...
A 35-year-old female patient presented with the following symptoms of Holmes-Adie syndrome: photophobia,enlargement of the left pupil unresponsive to light, Achilles areflexia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma.Simultaneously, celiac disease was diagnosed.Gluten-free diet resulted in a significant improvement of celiac disease,but not of autoimmune hepatitis. Autonomic neuropathy was proven by standard cardiovascular tests. The patient was a homozygous carrier for HLA DQ2 antigen characteristic for celiac disease and heterozygous for HLA DR3 B8 frequent in autoimmune liver diseases. Our novel observation on association of Holmes-Adie syndrome with autoimmune hepatitis and celiac disease is suggestive for a common immunological background for all three entities present in a patient with mesenteric multicystic lymphangioma.
Topics: Adie Syndrome; Adult; Celiac Disease; Female; Hepatitis, Autoimmune; Humans; Lymphangioma, Cystic; Peritoneal Neoplasms
PubMed: 16552828
DOI: 10.3748/wjg.v12.i9.1485 -
Journal of Family Medicine and Primary... Apr 2019Ross syndrome is diagnosed by the presence of the characteristic triad of segmental anhidrosis, depressed deep tendon reflex, and tonic pupils. It is a rare,...
Ross syndrome is diagnosed by the presence of the characteristic triad of segmental anhidrosis, depressed deep tendon reflex, and tonic pupils. It is a rare, misdiagnosed autonomic disorder with less than 80 cases reported in the world literature. Two representative cases of Ross syndrome are presented with their laboratory correlates and relevant review of literature. Both cases (aged 35 and 58) presented with complaint of decreased sweating over one half of the face and ipsilateral upper limb and trunk and contralateral lower limb. There was compensatory increased sweating and hyperpigmentation over the remaining parts of the body. The duration of symptoms was 2 years and 15 days. The patients had variegated skin color as per the above distribution and hyporeflexia in lower limbs. One patient also had Holmes-Adie pupil. Iodine test showed hypohidrosis in the described areas, which was confirmed by skin biopsy in both cases. The patients were treated symptomatically with incomplete relief. The authors aim to highlight this rare disorder that can be one of the causes of pathological sweating encountered in general practice and the challenges in its management.
PubMed: 31143750
DOI: 10.4103/jfmpc.jfmpc_151_19 -
Scientific Reports Jan 2020Intrinsically photosensitive retinal ganglion cells (ipRGCs) control non-visual light responses (e.g. pupillary light reflex and circadian entrainment). Patients with...
BACKGROUND
Intrinsically photosensitive retinal ganglion cells (ipRGCs) control non-visual light responses (e.g. pupillary light reflex and circadian entrainment). Patients with diabetic retinopathy (DR) show reduced ipRGC function, as inferred by abnormalities in the post illumination pupil response (PIPR). We explored whether ipRGC function in DR is associated with circadian outputs and sleep/wake behavior.
METHODS
Forty-five participants (15 without diabetes, 15 with type 2 diabetes (T2D) and no DR, 15 with T2D and DR) participated. ipRGC function was inferred from the PIPR (pupil size following stimulus offset). Circadian outputs were melatonin amplitude (overnight urinary 6-sulfatoxymelatonin (aMT6s)) and timing (dim light melatonin onset (DLMO)), and evening salivary cortisol levels. Sleep/wake patterns were measured with wrist actigraphy and insomnia symptoms were assessed subjectively.
RESULTS
Patients with T2D and DR had smaller PIPR and lower urinary aMT6s than other groups (p < 0.001). In adjusted regression models, smaller PIPR was associated with lower urinary aMT6s (β = 4.552, p = 0.005). Patients with DR were more likely to have no detectable DLMO (p = 0.049), higher evening salivary cortisol, greater insomnia symptoms and greater sleep variability compared to other groups. Sleep duration, efficiency and rest-activity rhythms were similar.
CONCLUSION
Reduced ipRGC function in DR is associated with circadian dysregulation and sleep disturbances, although a causal relationship cannot be established in this cross-sectional study. Prospective mechanistic and intervention studies examining circadian and sleep health in these patients are warranted.
Topics: Adie Syndrome; Aged; Cells, Cultured; Circadian Clocks; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Female; Humans; Hydrocortisone; Male; Melatonin; Middle Aged; Reflex, Pupillary; Retinal Ganglion Cells; Sleep Disorders, Circadian Rhythm; Sleep Initiation and Maintenance Disorders
PubMed: 32005914
DOI: 10.1038/s41598-020-58205-1