Adie syndrome, also referred to as Holmes-Adie syndrome is defined as a neurological disorder that affects the autonomic nervous system and the pupil of the eye. This disorder is characterized by an absence of deep tendon reflexes and having one pupil that is larger than the other. The Achilles tendon is most often affected by the loss of deep tendon reflexes. The eye with the larger pupil tends to constrict abnormally slowly when exposed to bright light. This syndrome is thought to be caused by a bacterial or viral infection. The infection leads to damage and inflammation to the ciliary ganglion and spinal ganglion neurons. This disorder often starts out only affecting one eye and over time it begins to affect the other eye as well. This syndrome is diagnosed most often in young women.
The symptoms of this syndrome affect each individual differently. Some patients only experience a few of the symptoms and some experience several of the symptoms. The symptoms also vary greatly in frequency and intensity among individuals. The symptoms of this syndrome include sensitivity to light, loss of tendon reflexes, pupil responding slowly to light, unequal pupils and headache. The loss of tendon reflexes most often affects the Achilles tendon and the knee jerk reflex. Some patients also experience excessive sweating and this sweating sometimes only affects one side of the body. Some patients will also experience abnormalities of the cardiovascular system. The symptoms of this syndrome can appear in association with other neurological diseases or on their own. Other neurological diseases that they may occur with include migraine headaches or Sjogren’s syndrome.
Can This Syndrome be Treated?
Currently, there is no treatment for Adie syndrome, but most of the symptoms can be managed. Those with impaired vision can wear reading glasses. Constricted pupils can be dilated with pilocarpine drops. Severe headaches or migraines can be treated with medications. The excessive sweating can be controlled by a surgical procedure called thoracic sympathectomy. This procedure controls excess sweating by severing the sympathetic nerve. This syndrome is not disabling or life-threatening. However, some symptoms may progress and the deep tendon reflex loss is permanent.
NINDS. (2007). What is Adie Syndrome? Retrieved on July 27, 2009 from Website: https://www.ninds.nih.gov/disorders/holmes_adie/holmes_adie.htm