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Article
June 1968

TONIC PUPILS AND ABSENT TENDON REFLEXES: A BENIGN DISORDER SUI GENERIS; ITS COMPLETE AND INCOMPLETE FORMS

Arch Neurol. 1968;18(6):710-715. doi:10.1001/archneur.1968.00470360132016
Abstract

Every experienced neurologist has seen a few patients with absence of the tendon reflexes for which no cause could be found. Acting on the suggestion of Dr. James Collier, I mention these cases here and submit that some of them are incomplete examples of this disorder. For proof I await a case in which a tonic pupil appears under observation.

If my views are correct the disorder I am describing may manifest itself in the folowing forms:—

(1) The complete from —typical tonic pupil and absence of reflexes.

(2) Incomplete forms: (a) tonic pupil alone; (b) atypical phases of the tonic pupil alone ("iridoplegia"; "internal ophthalmoplegia"); (c) atypical phases of the tonic pupil with absent reflexes; (d) absent reflexes alone.

The Tonic Pupil.  In its most characteristic form the tonic pupil is usually unilateral and almost always larger than its normal fellow; it is never miotic.

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