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Pupillary abnormalities (Argyll Robertson pupil (Pupillary light-near…
Pupillary abnormalities
Argyll Robertson pupil (Pupillary light-near dissociation)
no direct or consensual light reflex
accommodartion-convergence intact
Lesion in pretectal nuclei
DM
Neurosyphilis
Relative afferent (Marcus Gunn) pupil
Lesion of afferent limb of pupillary light reflex
MS
Test: swinging flash-light
in normal eye
pupils constrict fully
in MG pupil
poor constriction
again in MG pupil
dilation in both pupils
stimulus carried through CN II is weaker
Horner Syndrome
Adie pupil
lesion of 1 or both ciliary ganglia
dilated pupil reacts sluggishly to light
Better to accommodation
women
() with loss of knee jerks (muscle stretch reflexes)
Transtentorial or uncal herniation
unilateral dilated pupil
Elevated ICP, herniation, CN III compression
fixed and dilated pupil, down and out eye, ptosis