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Article
February 1936

THE PUPILLARY REACTIONS IN COMBINED LESIONS OF THE POSTERIOR COMMISSURE AND OF THE PUPILLODILATOR TRACTS: A CONTRIBUTION TO THE PATHOGENESIS OF THE ARGYLL ROBERTSON PUPIL

Author Affiliations

Instructor of Ophthalmology, Georgetown University WASHINGTON, D. C.; Professor of Experimental and Applied Neurology, Temple University PHILADELPHIA
From the Department of Experimental Neurology, D. J. McCarthy Foundation, Temple University School of Medicine, Philadelphia.

Arch Ophthalmol. 1936;15(2):195-216. doi:10.1001/archopht.1936.00840140045003
Abstract

Attempts to localize the anatomic lesion in cases of the Argyll Robertson pupil were recently concentrated on the posterior commissure, a system of fibers that cross the midline dorsal to the sylvian aqueduct in the most cranial part of the mesencephalon. Particularly the anatomic studies of Lenz1 and Papez and Freeman2 and the experiments of Sachs3 and of Ranson and Magoun4 show that afferent fibers of the pupilloconstrictor light reflex arc enter the posterior commissure and have here at least a partial decussation. Thus the theory of Behr5 seemed very promising ; this author explains the double-sided Argyll Robertson pupil by a lesion of the pupillomotor fibers at the place of decussation in the midbrain and the unilateral Argyll Robertson pupil by a lesion between the decussation in the midbrain and the sphincter nucleus, although Karplus and Kreidl6 had elicited pupillary contraction

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