Sinus arrhythmia and pupil size in Chiari I malformation: evidence of autonomic dysfunction.
In a prospective study on latent autonomic dysfunction in the Chiari type I malformation, 15 patients were examined for degree of sinus arrhythmia in the supine and the sitting positions with a deep breathing test, and for pupil size and function with electronic pupillometry after sympathicomimetic eyedrop stimulation. The 5 patients with brainstem signs had a marked disturbance of sinus arrhythmia, which was more pronounced in the supine than in the sitting position. The clinical signs suggested a dysfunction of the reflex centers in the medulla rather than of the lower cranial nerves. The patients also tended to have more anisocoria than healthy controls, but no clear-cut pattern existed as to pupil dysfunction. Of the 4 patients with syringomyelia, however, the two with the most extensive cord cavitations had a Horner-like pupil reaction ipsilaterally to a marked hand wasting, indicating a sympathetic lesion at the T1 level of the cord.
Stovner
L J
LJ
Department of Neurology, Trondheim University Hospital, Norway.
Kruszewski
P
P
Shen
J M
JM
D000328:Adult; D000368:Aged; D015875:Anisocoria / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis; D001146:Arrhythmia, Sinus / Q000175:diagnosis / Q000209:etiology*; D001933:Brain Stem / Q000503:physiopathology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006732:Horner Syndrome / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011187:Posture; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013595:Syringomyelia / Q000209:etiology / Q000503:physiopathology
D009883:Ophthalmic Solutions