Abstract:We assume that in our case the pupillotonia as well as the hemiatrophia faciei and the epilepsy is caused by a common autoimmune factor. All other aetiologies for these three diseases were excluded. Furthermore, the occurrence of pupillotonia, hemiatrophia faciei and epilepsy was simultaneous.
“…Aynaci et al [ 16 ] described a child with hemifacial atrophy features without any neurological deficiency, with Adie's syndrome on the affected side of the face—with mydriasis, no reaction to light, and with a slow reaction to convergence and accommodation (tonic pupil). Schnitzler et al [ 17 ] have reported a 25-year-old patient who at the age of 14 had a tonic pupil on the right side and epilepsy attacks. Both these patients had Adie's syndrome in which Adie's tonic pupil is a part of the immunological etiology.…”
We report a rare association of Adie's tonic pupil in a patient with systemic sclerosis who was otherwise systemically stable. This paper is an effort to unravel whether the tonic pupil and systemic sclerosis are an association by chance (which may be the case) or systemic sclerosis is the source of the tonic pupil.
“…Aynaci et al [ 16 ] described a child with hemifacial atrophy features without any neurological deficiency, with Adie's syndrome on the affected side of the face—with mydriasis, no reaction to light, and with a slow reaction to convergence and accommodation (tonic pupil). Schnitzler et al [ 17 ] have reported a 25-year-old patient who at the age of 14 had a tonic pupil on the right side and epilepsy attacks. Both these patients had Adie's syndrome in which Adie's tonic pupil is a part of the immunological etiology.…”
We report a rare association of Adie's tonic pupil in a patient with systemic sclerosis who was otherwise systemically stable. This paper is an effort to unravel whether the tonic pupil and systemic sclerosis are an association by chance (which may be the case) or systemic sclerosis is the source of the tonic pupil.
Cranial imaging in isolated tonic pupil is not helpful. Because of therapeutic implications, diagnostic evaluation can be recommended only in patients older than 50 years to exclude giant cell arteritis and syphilis.
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