title: Pupil abnormalities in selected autonomic neuropathies.
abstract: Examination of the pupil provides an opportunity to detect disturbances in the autonomic innervation of the eye. The pupil is frequently affected in patients with generalized autonomic neuropathies. This literature review confirms a high prevalence of sympathetic deficits and parasympathetic deficits in acute or subacute dysautonomia, diabetes, amyloidosis, pure autonomic failure, paraneoplastic syndromes, Sjögren syndrome, familial dysautonomia, and dopamine beta-hydroxylase deficiency. It confirms the relative scarcity of a pupil abnormality in patients with multiple system atrophy. There are difficulties in clinical diagnosis of pupil abnormalities and interpretation of pupil pharmacologic tests, particularly when combined sympathetic and parasympathetic deficits are present.
authors.affiliation: Department of Neuro-ophthalmology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: Fion D
authors.initials: FD
authors.lastname: Bremner
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Smith
mesh_terms: D000686:Amyloidosis / Q000150:complications; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D048909:Diabetes Complications / Q000150:complications; D006801:Humans; D016239:MEDLINE / Q000706:statistics & numerical data; D019578:Multiple System Atrophy / Q000150:complications; D020361:Paraneoplastic Syndromes, Nervous System / Q000150:complications; D011681:Pupil Disorders / Q000209:etiology*