![]() ![]() However, it may be noted that the tonic pupil was initially described in 1931 nearly synchronously by Adie, Morgan, Symonds, and Holmes in (2-4) EpidemiologyĪdie tonic pupil has a prevalence of population and occurs in a 2.6:1 female to male ratio with an average age of onset of 32 years (Thompson, 590). The entity is named after William John Adie, an Australian neurologist who extensively described the features. Patients may also present with decreased deep tendon reflexes in the full Holmes-Adie Syndrome. Constriction is typically more notable with the near reaction and typically remains tonically constricted with slow re-dilation with segmental paralysis of the iris sphincter. The affected pupil, either unilateral or bilateral typically initially appears abnormally dilated at rest and has poor or sluggish pupillary constriction in bright light. Tonic Pupil ICD-10: H57.051 (right), H57.052 (left), H57.053 (bilateral)Īdie tonic pupil, known as Adie’s Syndrome or Holmes-Adie Syndrome, is a disorder in which there is parasympathetic denervation of the afflicted pupil resulting in a poor light but better and tonic near constriction. 2.4 Differential diagnosis and additional tests.Neurosyphilis tabes dorsalis syphilitic meningitis Treponema pallidumm (MeSH). This article reviews the definition of aetiology, pathogenesis, clinical manifestations, diagnosis and treatment of neurosyphilis, with special attention to the presence of neurosyphilis with co-infection with HIV and its relevance to clinicians in the field of neurology. The treponemal tests developed in the hospitalization were positive, an abnormal CSF was obtained due to the presence of hyperprotein spinal cord, as well as anti-treponema pallidum antibodies in 6.56 positive in CSF, the diagnosis of tabes dorsalis was considered, for which treatment with penicillin was started intravenous crystalline 24 million international units (IU) day, for 14 days, with favorable clinical evolution. ![]() We present the case of a man in his fifth decade of life with human immunodeficiency virus (HIV) infection without antiretroviral therapy, with subacute fever, compromise of higher mental functions, Argyll Robertson pupil, myoclonus, and ataxic march. Patients with co-infection with HIV may have an earlier development of neurological characteristics than people without the infection, as well as a high probability of an incomplete response to treatment. Follow-up includes follow-up of serological and CSF tests in specific patients. The management of neurosyphilis is limited to receiving penicillin therapy. The importance in its diagnosis derives in avoiding the complications and potentially serious sequelae of the evolution of the disease without treatment. Since, to date, there is no highly specific and sensitive test, the diagnosis is based on clinical suspicion, serological studies, and the presence of CSF abnormalities. The early stages include asymptomatic meningitis, symptomatic meningitis, gum syphilis, and meningovascular syphilis, while the late stages include paralytic dementia and tabes dorsalis. It has been divided into early and late stages. It can occur at any time during the course of syphilis, and enters the body through the cousin-infection derived from primary chancre syphilitic, most patients generate an effective immune response that prevents the development of complications of infection in the CNS, however, some patients do not effectively eliminate the invasion to the CNS, thus developing asymptomatic or symptomatic neurosyphilis. ![]() Neurosyphilis is an infection caused by the bacterium Treponema pallidum subspecies pallidum (T. Tabes dorsalis and syphilitic meningitis in a patient with human immunodeficiency virus. NASSAR TOBON, Andrea Catalina RIVERA ROJAS, Neiby Johana MORA MENDEZ, Javier Mauricio and GOMEZ SUAREZ, Andrés Mauricio. ![]()
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