Tonic pupils with acute ophthalmoplegic polyneuritis

Autor(es): Keane J R


Resumo: Two patients with the symmetrical ophthalmoplegic variant of acute idiopathic polyneuritis (Fisher's syndrome) developed bilateral dilated pupils with cholinergic supersensitivity and light-near dissociation (tonic pupils), indicating involvement of the postganglionic parasympathetic neuron within the orbit. Supranuclear eye movement dysfunction also was present, indicated by relative levator sparing in both patients and by preservation of Bell's phenomenon in 1 patient despite paralysis of voluntary upward gaze. The lesions that produce the eye signs of ophthalmoplegic polyneuritis are not necessarily restricted to the cranial nerve trunks. The present cases support a relationship between the ophthalmoplegic variant of the Guillain-Barré syndrome and acute postinfectious encephalomyelitis (brainstem encephalitis) on the one hand, and idiopathic autonomic neuropathies such as the Holmes-Adie syndrome and pandysautonomia on the other.


Imprenta: Annals of Neurology, v. 2, n. 5, p. 393-396, 1977


Identificador do objeto digital: 10.1002/ana.410020508


Descritores: Guillain-Barre Syndrome - Cell ; Guillain-Barre Syndrome - Clinical examination


Data de publicação: 1977