We present a 37-year-old female patient diagnosed with unilateral hyperhidrosis coincident with Holmes-Adie syndrome because of this unusual presentation. [ncbi.nlm.nih.gov]

• Cranial Neuropathy

  We report a case of a Holmes-Adie syndrome variant with hitherto unreported cranial neuropathy. A 41 year old woman developed insidious onset of sensory symptoms related to her left trigeminal and chorda tympani nerves over a few months. [ncbi.nlm.nih.gov]

  Hereditary motor and sensory neuropathy type I (HMNS I) associated with cranial neuropathy: an autopsy case report. Acta Neurol Scand, 1990; 82: 368–373. PubMed Google Scholar [15] Ulrich J. Morphological basis of Adie's syndrome. [link.springer.com]

  Koh et al. described dysautonomic syndrome as a new finding due to COVID-19, including Adie's tonic pupil, in their study.[2] Later than, Ordás et al. reported SARS-CoV-2 related unilateral tonic pupil accompanying cranial neuropathy, 3 weeks after COVID [journals.lww.com]

• Cranial Nerve Involvement

  Cranial nerve involvement (II, III, IV, V, VI), mostly due to inflammation or infection of the orbit or the trigeminal nerve, could be a rare complication. [intranet.tdmu.edu.ua]

Ophthalmologic examination confirmed Holmes-Adie syndrome (HAS), and peripheral distal polyneuropathy, orthostatic hypotension and leg hyperhidrosis were detected on further workup. [ncbi.nlm.nih.gov]

“Their deep tendon reflexes were also tested clinically and a full autonomic and neurological workup was performed to look for an underlying cause for their Harlequin syndrome.” [eyeworld.org]

Can be dangerous if a manifestation Horner's syndrome (e.g. carotid dissection) or from damage to the third nerve (e.g. aneurysmal expansion) Consider further workup such as imaging if anisocoria is suspected to be from a pathologic process Relative Afferent [stanfordmedicine25.stanford.edu]

However, the specific workup for each patient will depend on the associated manifestations. Computed tomography and magnetic resonance imaging scans may be useful in the diagnostic testing of focal hypoactive reflexes. [statpearls.com]

• Human Parvovirus B19

  Less common causes of adie syndrome include infections like HIV[5], syphilis[6], varicella, lyme's disease[7], Human parvovirus-B19, autoimmune diseases like amyloidosis, sarcoidosis, guillain-barre syndrome, sjogren syndrome, polyarterities nodosa[8] [wikidoc.org]

  parvovirus-B19, human immunodeficiency virus, and Lyme disease,[5][6][7] ischemia due to lymphomatoid granulomatosis, migraine, and giant cell arteritis,[8][9] autoimmune disorders such as Sjogren syndrome, polyarteritis nodosa, sarcoidosis, systemic [statpearls.com]

• HLA-DR3

  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. [ncbi.nlm.nih.gov]

• HLA-DQ2

  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. [ncbi.nlm.nih.gov]

Thoracic sympathectomy, which severs the involved sympathetic nerve, is the definitive treatment for excessive sweating. × Treatment Doctors may prescribe reading glasses to compensate for impaired vision in the affected eye, and pilocarpine drops to [ninds.nih.gov]

The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s).[1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure, and should be applied three times daily [eyecare-information-service.org.uk]

Treatments of Adie’s Syndrome The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s). [whereincity.com]

[ edit ] The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s). [1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure. [1] Thoracic sympathectomy [en.wikipedia.org]

Although bronchodilator treatment improved the dyspnoea it did not prevent coughing. She had been hypertensive and noted that treatment with an angiotensin converting enzyme inhibitor exacerbated her cough and the drug was withdrawn. [jnnp.bmj.com]

Prognosis Holmes-Adie syndrome is not life-threatening or disabling. The loss of deep tendon reflexes is permanent. Some symptoms of the disorder may progress. [ninds.nih.gov]

This has a number of implications, including those relating to aetiology and prognosis. The authors recommend regular clinical and laboratory follow-up, especially of cardiovascular autonomic function, in patients with HAS. [ncbi.nlm.nih.gov]

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 [eyecare-information-service.org.uk]

What is the prognosis? What research is being done? Clinical Trials What is Holmes-Adie syndrome ? Holmes-Adie syndrome (HAS) is a neurological disorder affecting the pupil of the eye and the autonomic nervous system. [sweyeinstitute.com]

With appropriate treatment, the prognosis of Adie Syndrome is good Who gets Adie Syndrome? (Age and Sex Distribution) Women between the ages of 20 and 40 years are most susceptible to Adie Syndrome. [dovemed.com]

The HAS can be either idiopathic or associated with neuropathy of various etiology (autoimmune, paraneoplastic and infectious). In our patient, the pupillotonia was the first and early symptom of hitherto unrecognized HIV neuropathy. [ncbi.nlm.nih.gov]

A syndrome of unknown etiology and pathology characterized by tonic pupillary reactions with tendon reflexes possibly absent or diminished. [medical-dictionary.thefreedictionary.com]

It is thought to result from damage to the ciliary ganglion and the dorsal root ganglion by viral or bacterial infections, however, there are idiopathic etiologies 1,3. [radiopaedia.org]

Clinical aspects The etiology of AS is presumed to be either idiopathic or autoimmune, but may also occur secondary to other disorders, such as viral infections, trauma, tumors, diabetes mellitus, syphilis, vascular lesions with ischemia, autonomic neuropathies [accesspediatrics.mhmedical.com]

Adie syndrome is a relatively common neurological disorder of unknown etiology comprising unilateral or bilateral tonically dilated pupils with light-near dissociation and tendon areflexia. [statpearls.com]

[…] treatable by drug therapy. [1] Prognosis [ edit ] 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 [en.wikipedia.org]

Th e epidemiology of Sjogren’s syndrome. Clin Epidemiol 2014;6:247-55. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Th er 2009;11:229. [scopublicaciones.socoftal.com]

Careful clinical, diagnostic, and epidemiological studies are needed to help define the manifestations and burden of neurological disease caused by SARS-CoV-2. [journals.lww.com]

Abstract The pathophysiological mechanisms underlying benign areflexia were studied in six patients with Holmes-Adie syndrome. No impairment of sensory conduction velocity of sural nerve was found. [ncbi.nlm.nih.gov]

Pathophysiology Pupil size depends on the effects of the autonomic nervous system and the iris muscle, and numerous pathophysiological processes can cause anisocoria. [emedicine.medscape.com]

[…] loss of deep tendon reflexes, and abnormalities of sweating. [1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading. [3] Some individual with Adie syndrome may also have cardiovascular abnormalities. [4] Pathophysiology [en.wikipedia.org]

Disponible en ligne depuis le mercredi 20 septembre 2017 Doi : 10.1016/j.neucli.2017.08.001 Received : 20 June 2017 ; accepted : 25 August 2017 Areflexia in Holmes-Adie syndrome: A sign in search of its pathophysiology Aréflexie dans le syndrome de Holmes-Adie [em-consulte.com]

We can hope that Holmes-Adie Syndrome can be prevented and treated better in the days ahead. [weheartvision.com]

Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders, such as HAS. Select this link to view a list of studies currently seeking patients. [web.archive.org]

Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders, such as HAS. [sweyeinstitute.com]

Prevention of hip fracture in elderly people with use of a hip protector. ‏ [books.google.com]