WordNet

relating to or being the keynote of a major or minor scale; "tonic harmony"
a medicine that strengthens and invigorates (同)restorative
(music) the first note of a diatonic scale (同)keynote
lime- or lemon-flavored carbonated water containing quinine (同)tonic_water, quinine water
used of syllables; "a tonic syllables carries the main stress in a word" (同)accented
employing variations in pitch to distinguish meanings of otherwise similar words; "Chinese is a tonal language" (同)tonal
of or relating to or producing normal tone or tonus in muscles or tissue; "a tonic reflex"; "tonic muscle contraction"
the contractile aperture in the center of the iris of the eye; resembles a large black dot
young of any of various canines such as a dog or wolf (同)whelp

PrepTutorEJDIC

強壮剤;養毛剤,ヘアトニック / (精神的に)元気付けるもの / =tonic water / 主音(音階の中心となる第1音) / 強壮にする,元気付ける / 音調の / (音楽で)主音の
(一般にschoolに学ぶ)『生徒』;(個人指導を受けている)生徒,門下生,弟子
ひとみ,瞳孔(どうこう)
=puppy / (キツネ・オオカミ・アザラシなどの)子 / 〈雌犬が〉子犬を生む
(重量単位の)『トン』 / (容積単位の)トン(物によって異なり,木材では40立方フィート,小麦では20立方フィート) / 《話》大量(の…),多数(の…)《+of+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/14 21:51:00」(JST)

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Adie syndrome (/ˈeɪdi/), sometimes known as Holmes–Adie syndrome or Adie's tonic pupil, is a neurological disorder characterized by a tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation (i.e., light-near dissociation).^[1] It is frequently seen in females with absent knee or ankle jerks and impaired sweating. It is named after the British neurologist William John Adie. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and affects the pupil of the eye and the autonomic nervous system.^[1]

Signs and symptoms

Adie syndrome presents with three hallmark symptoms, namely at least one abnormally dilated pupil (mydriasis) which does not constrict in response to light, loss of deep tendon reflexes, and abnormalities of sweating.^[1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.^[2]

Pathophysiology

Pupillary symptoms of Holmes–Adie asyndrome are thought to be the result of a viral or bacterial infection that causes inflammation and damage to neurons in the ciliary ganglion, located in the posterior orbit, that provides parasympathetic control of eye constriction. Additionally, patients with Holmes-Adie Syndrome can also experience problems with autonomic control of the body. This second set of symptoms is caused by damage to the dorsal root ganglia of the spinal cord.^[1]

Diagnosis

Clinical exam may reveal sectoral paresis of the iris sphincter or vermiform iris movements. The tonic pupil may become smaller (miotic) over time which is referred to as "little old Adie's".^[3] Testing with low dose (1/8%) pilocarpine may constrict the tonic pupil due to cholinergic denervation supersensitivity.^[1] A normal pupil will not constrict with the dilute dose of pilocarpine.^[3] CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.^[4]

Treatment

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 is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.^[1]

Prognosis

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

It most commonly affects younger women (2.6:1 female preponderance) and is unilateral in 80% of cases.^[3] Average age of onset is 32 years.

References

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j National Institute of Neurological Disorders and Stroke. "Holmes-Adie syndrome Information Page". Retrieved 2008-01-21.
^ Stedman's Medical Dictionary, 27th Edition. 2000. ISBN 0-683-40007-X.
^ ^a ^b ^c Haines, Duane E. (2002). Fundamental Neuroscience, 2nd edition. ISBN 0-443-06603-5.
^ "Diagnosis of Adie syndrome". WrongDiagnosis.com. Retrieved 2008-01-21.

External links

Animation at mrcophth.com

UpToDate Contents

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1. 緊張性瞳孔 tonic pupil
2. 瞳孔不同患者へのアプローチ approach to the patient with anisocoria
3. 成人における第三脳神経（動眼神経）麻痺 third cranial nerve oculomotor nerve palsy in adults
4. 胃運動機能不全：病因、臨床症状、および診断 gastroparesis etiology clinical manifestations and diagnosis
5. シェーグレン症候群の臨床症状：腺外型疾患 clinical manifestations of sjogrens syndrome extraglandular disease

English Journal

Syndrome in question.

Dalapicola MC1, Veasey JV1, Lellis RF1.
Anais brasileiros de dermatologia.An Bras Dermatol.2016 Feb;91(1):111-2. doi: 10.1590/abd1806-4841.20163918.
Ross syndrome is a rare disease characterized by peripheral nervous system dysautonomia with selective degeneration of cholinergic fibers. It is composed by the triad of unilateral or bilateral segmental anhidrosis, deep hyporeflexia and Holmes-Adie's tonic pupil. The presence of compensatory sweati
PMID 26982793

Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children.

Pediatric Eye Disease Investigator Group.
Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus.J AAPOS.2016 Feb;20(1):78-81. doi: 10.1016/j.jaapos.2015.09.011.
A total of 27 children with esotropia (mean age, 3.9 years; range, 9 months to 13.8 years) were enrolled in a 9-month observational study following botulinum toxin A (BTX-A) injection of one (n = 7) or both (n = 20) medial rectus muscles. BTX-A dosage ranged from 3.0 to 6.0 units per muscle.
PMID 26917081

[Tonic pupil as an initial manifestation of Sjögren's syndrome].

Miranda Bacallado Y1, González Hernández A2, Tandón Cárdenes LA3, Curutchet Mesner L3.
Medicina clinica.Med Clin (Barc).2016 Jan 19. pii: S0025-7753(15)00654-5. doi: 10.1016/j.medcli.2015.11.028. [Epub ahead of print]
PMID 26804819

Japanese Journal

Tonic Pupil, from Dawn to Down

神経眼科 32(4), 419-425, 2015
NAID 130005121317

脳神経障害を合併しMRI にて三叉神経の腫大・造影効果を呈した急性自律性感覚性運動性ニューロパチーの1例

臨床神経学 53(2), 125-130, 2013
NAID 130004505500

臨床報告内眼筋障害が先行したFisher症候群

眼科 52(6), 813-817, 2010-06
NAID 40017177920

Related Pictures

★リンクテーブル★

リンク元	「瞳孔緊張症」「アディー瞳孔」「緊張性瞳孔」
拡張検索	「myotonic pupil」
関連記事	「tonic」「pup」

「瞳孔緊張症」

Adie's syndrome
	Bilateral mydriasis given the observational diagnosis Adie's pupils by an ophthalmologist
Classification and external resources
Specialty	ophthalmology
ICD-10	H57.0
ICD-9-CM	379.46
DiseasesDB	29742
MeSH	D015845
	[edit on Wikidata]