Currently, neurological diseases are gaining high prevalence. This is due to poor ecology, heredity, a large number of various infections, and so on. Among these defects is Adie's syndrome (Holmes-Adie), which occurs most often in people with damage to the postganglionic fibers of the eye, which occurs due to a bacterial infection. In this case, the pupil of the eye partially or completely loses the ability to narrow. It acquires an oval shape or becomes uneven, there is a segmental lesion of the iris.
Description
Holmes-Adie Syndrome – a neurological disorder that is characterized by constant dilation of the pupil, the reaction to light of which is very slow, but a pronounced reaction is observed with a bright close dissociation. So, when approaching, the pupil narrows rather slowly or does not narrow at all, and even more slowly returns to its original size, sometimes within three minutes. With a long stay in the dark, the patientpupillary dilation is observed. Adie's syndrome in neurology is associated with the fact that a bacterial infection contributes to damage to neurons in the cluster of nerve cells that are located in the part of the orbit that is located behind, and control the narrowing of the eye. In addition, in people with this disease, there is a violation of the autonomic control of the body, which is associated with damage to nerve cells in the spinal cord. A person's ankle is supported, sweating is disturbed. The disease happens:
- Congenital, which is characterized by dysfunction of the Achilles reflex, visual impairment when considering an object up close is not observed.
- Acquired, which is caused by impaired vision at close examination, which is corrected by instillation of miotic agents. Occurs after injuries, infections and poisoning.
Etiology and epidemiology
Adie's syndrome has not been fully studied to date, in some cases it is considered to be its symptom at the stage of development of autonomic failure. Most often, the disease occurs in the fairer sex at the age of about thirty-two years. Cases of family disease are known. National and racial characteristics do not play any role in this.
In most cases, the disease manifests itself unilaterally with mydriasis. This disease is quite rare, some sources indicate one case of pathology in twenty thousand people. These are most often single cases, but sometimes an anomaly can be observed in entire families. Children rarely get sickthis disease. A large number of patients seek help between the ages of twenty and fifty. The origin of the syndrome is unknown, it appears in people who do not have any eye pathologies. In rare cases, the disease occurs with injuries of the orbit, as well as as a result of metastasis of cancerous tumors into the orbit of the eye.
Reasons
Adie's syndrome causes are unclear at present. It is only known that the ciliary node, which is located in the orbit, is affected, this provokes an anomaly in the work of the muscles responsible for the ability to clearly see objects at a remote distance. The ability to see sometimes returns, but the pupil does not react to light. Doctors consider the main reasons for this pathology to be:
- avitaminosis and infectious diseases;
- congenital myotinia;
- eye herpes;
- ocular muscle atrophy that progresses;
- inflammation of the brain or its membranes.
Symptoms
Signs of the disease are three criteria:
- Pathologically dilated one pupil that does not respond to light.
- Loss of tendon reflexes
- Violation of sweating.
Other symptoms with such an ailment as Adie's syndrome can manifest themselves in photophobia, farsightedness, decreased vision, headache, decreased leg reflexes. Pupil size may change throughout the day. At first one eye is affected, but after a few years it is possibledefeat and the second eye.
The disease manifests itself immediately after a severe attack of headache, then mydriasis begins to develop, vision deteriorates, fogging appears when viewing objects that are close. In most cases, there is a loss of tendon reflexes, hyperthermia.
Adie syndrome: diagnosis
Diagnosis is possible using a slit lamp. A test is also carried out using "Pilocarpine", a solution of which is instilled into the eyes and the pupils are observed for the next twenty-five minutes. At the same time, the he althy eye does not show any reaction, the pupil narrows in the affected eye. Often, an MRI and CT scan is performed. The ciliary nerves can become inflamed in the presence of diphtheria, especially in the third week of the course of the disease. Then the pupils are restored. Adie's syndrome is very similar to A. Robertson's syndrome, which is characteristic of neurosyphilis, so diagnostic measures are taken to make an accurate diagnosis.
If a pupil pathology is observed, and the causes are unknown, an examination is performed with a slit lamp to exclude mechanical injuries of the iris, the presence of a foreign body, injury, inflammation, as well as adhesions, glaucoma.
Treatment
Usually, with such an ailment as Adie's syndrome, there is no cure. The therapy does not have the desired effect. Patients are assigned glasses that correct violations. Pilocarpine drops are also prescribed to correct an eye defect. Sweating disorders are treated withusing thoracic sympathectomy. There is no cure for this disease.
Forecast and prevention
All pathological changes in a disease such as Adie's syndrome are irreversible, so the prognosis is somewhat unfavorable. But the disease does not pose a threat to life and does not affect a person's ability to work. But in some cases, the disappearance of tendon reflexes can develop even more over time. Then both pupils are affected, acquire a small size and practically do not react to light. Treatment with drops "Pilocarpine" does not bring obvious results.
Preventive measures are aimed at the timely treatment of infectious diseases, which often give complications. You need to eat right and follow the daily routine. A he althy lifestyle helps to reduce the risk of developing various pathological conditions in the human body.
Thus, this disease is incurable, only a decrease in the manifestation of symptoms is possible, over time the disease can progress and lead to bilateral anomalies of the eyes. But the disease is not life-threatening, as no deaths have been observed with this disease.
