title: Bilateral tonic pupils associated with neurosyphilis.
abstract: BACKGROUND
  To describe 4 patients with bilateral tonic pupils in neurosyphilis.
  
  
  METHODS
  Four young men had pupillary abnormalities, which involved irregular shapes, large sizes, tonic reactions, and vermiform movements of both pupils with light-near dissociation. Cholinergic supersensitivity defined bilateral tonic pupils.
  
  
  METHODS
  Neurosyphilis was diagnosed in these patients on the basis of ocular and laboratory findings.
  
  
  CONCLUSIONS
  Bilateral tonic pupils may be important as initial findings in neurosyphilis. We conclude that patients with bilateral tonic pupils should undergo serologic tests for syphilis.
authors.affiliation: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sakai
authors.forename: Keigo
authors.initials: K
authors.lastname: Shikishima
authors.forename: Tokihide
authors.initials: T
authors.lastname: Mizobuchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kitahara
mesh_terms: D000328:Adult; D002555:Cerebrospinal Fluid / Q000166:cytology; D003937:Diagnosis, Differential; D016508:Fluorescent Treponemal Antibody-Absorption Test; D006801:Humans; D007964:Leukocytosis / Q000175:diagnosis; D008297:Male; D009494:Neurosyphilis / Q000150:complications* / Q000175:diagnosis; D015845:Tonic Pupil / Q000175:diagnosis / Q000209:etiology*