The exact relationship between syphilis and the two types of pupils (AR pupils and tonic pupils) is not known at the present time. During this period, the pupillary light reactions progress from slow, incomplete constrictions to complete loss of the light reflex. Kawasaki A. Physiology, assessment, and disorders of the pupil.

Juli 2015 um 10:16 Uhr bearbeitet. Beim Argyll-Robertson-Syndrom besteht zusätzlich eine Miosis (Enge der Pupillen). [5], The damaging lesion in Argyll Robertson pupils usually develops over a period of time, sometimes asymmetrically and sometimes at an uneven rate.

Letzterer ist der für die Pupillenverengung auf Licht verantwortliche Hirnbezirk. Studies have failed to demonstrate a focal localising lesion. In 1869 he published a paper giving the first description of unusual reactions of the pupils to light and accommodation in patients with tabes dorsalis(syphilis affecting the spinal cord). AR pupils are extremely uncommon in the developed world. Ils sont un signe très spécifique de neurosyphilis. Management should be aimed at treating the primary cause of the pupillary abnormality. That's it. [1], The characteristic light-near dissociation of AR pupils occurs most often bilaterally but may be unilateral in some patients. [3] It is not known whether neurosyphilis itself (infection by Treponema pallidum) can cause tonic pupils, or whether tonic pupils in syphilis simply reflect a coexisting peripheral neuropathy. 1869 ; 15:487-93.

They are a specific sign of neurosyphilis.In general, pupils that accommodate but do not react are said to show light-near dissociation (i.e. It will enhance any encyclopedic page you visit with the magic of the WIKI 2 technology. La dernière modification de cette page a été faite le 27 décembre 2018 à 18:13. Le signe d'Argyll Robertson, (ou Pupille d'Argyll Robertson) est une abolition du réflexe photomoteur (contraction des pupilles à la lumière), avec conservation de la réaction d'accommodation (contraction des pupilles en même temps que les muscles du cristallin lors de la mise au point focale à la distance). Adie’s syndrome: some new observations. Edin Med J. The pupils are noticeably able to accommodate near targets, with subsequent normal and brisk redilation to far. April 2018 um 20:03 Uhr bearbeitet.

Adie's pupil is caused by damage to peripheral pathways to the pupil (parasympathetic neurons in the ciliary ganglion that cause pupillary constriction to bright light and with near vision). 3) Dorsal midbrain syndrome (Parinaud Syndrome, Sylvian Aqueduct Syndrome, Pretectal Syndrome), 4) Aberrant regeneration of the third nerve. Dieser Artikel behandelt ein Gesundheitsthema. Thompson HS. San Francisco, CA: American Academy of Ophthalmology; 2019; 284-297. Der Kern selbst ist zwar intakt – nicht jedoch sein Afferenzweg, der in der erwähnten prätektalen Region verläuft. Les deux types différents de quasi-réponse sont causés par des processus de maladie sous-jacents différents. However, because this sign is associated with neurosyphilis, it should be treated with crystalline penicillin 24 mU intravenous per day for 10 to 14 days. Specifically, a lesion of the rostral midbrain within the dorsal aspect of the Edinger-Westphal nucleus can interrupt the pretectal oculomotor light reflex fibers. The AR pupil was named after Douglas Moray Cooper Lamb Argyll Robertson, a Scottish ophthalmologist who noted the association with syphilis in 1869. Die Konvergenzreaktion ist dagegen intakt. 6. This uncommon syndrome involves vertical gaze palsy associated with pupils that “accommodate but do not react. [3] Douglas Moray Cooper Lamb Argyll Robertson, a Scottish ophthalmologist and surgeon, originally described this abnormal pupil finding in 1868.[1]. In: Walsh and Hoyt’s Clinical Neuro-Ophthalmology. The near response in AR pupils is brisk and immediate. Es handelt sich dabei um eine bestimmte Form der Reflektorischen Pupillenstarre, die als typisch für die Neurolues (Befall des Nervensystems im Spätstadium einer Syphiliserkrankung) gilt. Ursache der Pupillenstarre ist eine Läsion des Gehirngewebes zwischen prätektaler Region und Nucleus accessorius des Nervus oculomotorius (Nucleus Edinger-Westphal). Es handelt sich dabei um eine bestimmte Form der Reflektorischen Pupillenstarre, die als typisch für die Neurolues (Befall des Nervensystems im Spätstadium einer Syphiliserkrankung) gilt. [2] In addition, AR pupils are accompanied with frequent iris atrophy. Er dient, https://de.wikipedia.org/w/index.php?title=Argyll-Robertson-Syndrom&oldid=176346220, „Creative Commons Attribution/Share Alike“, Anomalien der Pupillenreaktion bei anderenorts klassifizierten Krankheiten. Pearce JMS. Le signe d'Argyll Robertson, (ou Pupille d'Argyll Robertson) est une abolition du réflexe photomoteur (contraction des pupilles à la lumière), avec conservation de la réaction d'accommodation (contraction des pupilles en même temps que les muscles du cristallin lors de la mise au point focale à la distance). Les voies d'accommodation - les voies menant au noyau d'Edinger-Westphal qui provoquent une constriction des pupilles avec une vision de près - seraient épargnées par leur parcours plus ventral dans le tronc cérébral. The Academy uses cookies to analyze performance and provide relevant personalized content to users of our website. There is continued interest in the underlying pathophysiology, but the scarcity of cases makes ongoing research difficult.

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These pupils will not be small and will not show iris abnormalities or irregularity. In general, pupils that accommodate but do not react are said to show light-near dissociation (i.e., it is the absence of a miotic reaction to light, both direct and consensual, with the preservation of a miotic reaction to near stimulus (accommodation/convergence).[1]. “Syphilis”. Argyll Robertson DMCL. They are a highly specific sign of neurosyphilis; however, Argyll Robertson pupils may also be a sign of diabetic neuropathy. L'accommodation est épargnée, car la voie de ce réflexe est différente de celle du réflexe photomoteur. [1][2], Patients with Argyll Robertson pupils typically present with miotic pupils (<2mm in diameter) that do not dilate fully in dim light. McGee S. The Pupils. La littérature plus ancienne sur les pupilles atteints de RA ne donnait pas les détails de la constriction pupillaire (vive contre tonique) nécessaires pour distinguer les deux types de pupilles. [5] Over time, Argyll Robertson pupils eventually lose their near constriction as well and become miotic, immobile pupils. You could also do it yourself at any point in time. Dernière modification le 27 décembre 2018, à 18:13, https://fr.wikipedia.org/w/index.php?title=Signe_d%27Argyll_Robertson&oldid=155166658, licence Creative Commons attribution, partage dans les mêmes conditions, comment citer les auteurs et mentionner la licence. [3], It is important to check patient history for diabetes, trauma, and other neurologic diseases. Des pupilles toniques peuvent survenir dans la neurosyphilis. There is no definite treatment, but, because syphilis may be an underlying cause, it should be treated.

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