Hello nicky,

I'm 30 years old, i'm french (i live near paris), and
i work in biological research institute.

Past years; a neurologist diagnostic me an holmes
adies syndrome after a consultation for aniscoria.
I'm not take pilocarpine because is not a problem for
me, just little difficulties for accomodation of
light (dark room to bright room, and near vision
accomodation in some cases). I haven't over
dysfonction.

But i decide to do some research in the net about
this syndrome. I find some informations about this,
particulary in medical database (like pubmed). To
resume for you :

The Holmes-adies syndrome (HAS) is characterised by a
initially monolateral, then bilateral enlargement of
the pupil with delayed responses to the near vision
effort, with delayed redilatation. The yearly
incidence of this condition has be estimated at
4.7/100.000, more commun in women. This syndrom is
usally sporadic. So they are somes problems of
blurred vision in the patients with HAS when they
change from near to far vision..

Very few neuropathological examination are avaible.
Partial or total loss of neurons of the cilary
ganglion on the same side as the tonic pupil. The
cause of this neuronal degeneration is not know, but
some studies suggest it is unlikely to be the result
of infection of conventional bacterial or viral
origin or other inflammatory disease.

The abscence of deep tendons reflexes is also
characteristic of HAS, with loss of the achilles
tendon reflex being most frequent. this areflexia is
expand in the time, with a rate of 4% by years. Some
studies suggest a progressive disease. Some hypotesis
are availble of this areflexia, but is very complex.

The association between HAS and more widespread
autonomic disfonction remains controversial. Single
case reports or series of HAS have been reported,
associated with sweating or cardiovascular
dysfonction, diarrheoa, coughing, loss off of
flushing and sweating dysfonction, migraine,
myopathie and link with over syndrome like ross
syndrome, harlequin syndrome, sjogren's syndrome.

I succed to get scientists papers about this, like :
Holmes adie syndrome (data resume 2000),
Neurophysiological evaluation of areflexia in HAS
(1999),
On cause of tendon areflexia in HAS (1994),
HAS as the inital sign of primary Sjogren Syndrome
(1997),
Adie syndrome, evidence for refractive error and
accomodative asymetriy as the cause of amblyopia
(1999),
Chronic cought in HAS, association in five cases with
autonomic dysfonction (1998).

If you are interested, i can send you.

I take advantage of this mail to appeal to people of
this liste, if somebody can procure me one of this
article, i very interresting to read this, many
thanks,

" Adie's tonic pupil secondary to migraine " by
PurvinVA, J Neuroophtalmol 1995 mar;15(1):43-44
" Asymptomatic autonomic and sweat dysfonction in
patients with Adie's syndrome " by Jacobson DM, Hiner
BC, J Neuroopthalmol 1998 jun;18(2):143-7.
" Adie's syndrome. Sweating disturbance and diarrhoea
- a new syndrome? By Burns R, Wing L, Clin Exp Neurol
1980;17:243


Bye,

Arnaud.



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