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C J Mathias - One of the best experts on this subject based on the ideXlab platform.

  • progression of cardiovascular autonomic dysfunction in holmes Adie Syndrome
    Journal of Neurology Neurosurgery and Psychiatry, 2011
    Co-Authors: P Guaraldi, C J Mathias
    Abstract:

    The Holmes-Adie Syndrome (HAS) is a disorder of unknown aetiology comprising unilateral or bilateral tonic pupils with near light dissociation and tendon areflexia. Although considered to be benign, troublesome symptoms may result from autonomic disturbances, affecting vasomotor, sudomotor and respiratory function. It is unclear if the autonomic manifestations of the disease remain stable or progress, as longitudinal studies with detailed autonomic assessments have not been described. The authors report four HAS patients studied at intervals over 16, 8, 4 and 2eyears with cardiovascular autonomic tests (head-up tilt, isometric exercise, mental arithmetic, cutaneous cold, deep breathing, Valsalva manoeuvre and standing). In each, there was progression of cardiovascular autonomic deficits with time, accompanied by symptomatic worsening. These observations in HAS, for the first time, indicate progression of cardiovascular autonomic dysfunction of clinical significance. This has a number of implications, including those relating to aetiology and prognosis. The authors recommend regular clinical and laboratory follow-up, especially of cardiovascular autonomic function, in patients with HAS.

  • chronic cough in the holmes Adie Syndrome association in five cases with autonomic dysfunction
    Journal of Neurology Neurosurgery and Psychiatry, 1998
    Co-Authors: J Kimber, D Mitchell, C J Mathias
    Abstract:

    The Holmes-Adie Syndrome consists of unilateral or bilateral tonic pupils with near light dissociation and tendon areflexia. It is associated with autonomic disturbances affecting sudomotor and vasomotor function. Five such patients are reported on who also had a troublesome chronic dry cough, which was of unknown aetiology and was resistant to a range of treatments. The cough may be related to involvement of afferent or efferent pathways in the vagus. Chronic cough may be an accompaniment in the Holmes-Adie Syndrome, like other forms of autonomic dysfunction.

Ferenc Szalay - One of the best experts on this subject based on the ideXlab platform.

  • CASE REPORT Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    2015
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles arefl exia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a signifi cant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standar

  • Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    World journal of gastroenterology, 2006
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles areflexia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a significant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standard cardiovascular tests. The patient was a homozygous carrier for HLA DQ2 antigen characteristic for celiac disease and heterozygous for HLA DR3 B8 frequent in autoimmune liver diseases. Our novel observation on association of Holmes-Adie Syndrome with autoimmune hepatitis and celiac disease is suggestive for a common immunological background for all three entities present in a patient with mesenteric multicystic lymphangioma.

Stephen E Smith - One of the best experts on this subject based on the ideXlab platform.

  • bilateral tonic pupils holmes Adie Syndrome or generalised neuropathy
    British Journal of Ophthalmology, 2007
    Co-Authors: Fion Bremner, Stephen E Smith
    Abstract:

    Aim: To compare the pupil signs in patients with bilateral pupillotonia caused by Holmes–Adie Syndrome or generalised peripheral neuropathy. Methods: Infrared video pupillographic techniques were used to measure a number of pupil variables in patients with Holmes–Adie Syndrome, generalised neuropathy (various aetiologies) and healthy age-matched control subjects. Results: Regardless of aetiology, the patients generally had pupil signs typical of pupillotonia (small dark diameters, large light diameters, tonic near responses, attenuated light responses with light-near dissociation, and sector palsy). However, significant differences were found in the prevalence and magnitude of several pupil variables in the two patient groups. In particular, sector palsy and anisocoria exceeding 1 mm (in the light) were seen much more commonly in Holmes–Adie patients than patients with generalised neuropathy. The presence of both these pupil signs can be used to distinguish between these diagnoses with a sensitivity of 58% and a specificity of 90%. Conclusions: The tonic pupils of patients with Holmes–Adie Syndrome are significantly different to those found in patients with generalised neuropathy; recognition of these differences may allow distinction between these diagnoses.

  • scientific report bilateral tonic pupils holmes Adie Syndrome or generalised neuropathy
    2007
    Co-Authors: F D Bremner, Stephen E Smith
    Abstract:

    ..... Aim: To compare the pupil signs in patients with bilateral pupillotonia caused by Holmes–Adie Syndrome or generalised peripheral neuropathy. Methods: Infrared video pupillographic techniques were used to measure a number of pupil variables in patients with Holmes–Adie Syndrome, generalised neuropathy (various aetiologies) and healthy age-matched control subjects. Results: Regardless of aetiology, the patients generally had pupil signs typical of pupillotonia (small dark diameters, large light diameters, tonic near responses, attenuated light responses with light-near dissociation, and sector palsy). However, significant differences were found in the prevalence and magnitude of several pupil variables in the two patient groups. In particular, sector palsy and anisocoria exceeding 1 mm (in the light) were seen much more commonly in Holmes– Adie patients than patients with generalised neuropathy. The presence of both these pupil signs can be used to distinguish between these diagnoses with a sensitivity of 58% and a specificity of 90%. Conclusions: The tonic pupils of patients with Holmes–Adie Syndrome are significantly different to those found in patients with generalised neuropathy; recognition of these differences may allow distinction between these diagnoses.

Timea Csak - One of the best experts on this subject based on the ideXlab platform.

  • CASE REPORT Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    2015
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles arefl exia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a signifi cant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standar

  • Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    World journal of gastroenterology, 2006
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles areflexia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a significant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standard cardiovascular tests. The patient was a homozygous carrier for HLA DQ2 antigen characteristic for celiac disease and heterozygous for HLA DR3 B8 frequent in autoimmune liver diseases. Our novel observation on association of Holmes-Adie Syndrome with autoimmune hepatitis and celiac disease is suggestive for a common immunological background for all three entities present in a patient with mesenteric multicystic lymphangioma.

Andrea Horváth - One of the best experts on this subject based on the ideXlab platform.

  • CASE REPORT Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    2015
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles arefl exia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a signifi cant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standar

  • Holmes-Adie Syndrome, autoimmune hepatitis and celiac disease: A case report
    World journal of gastroenterology, 2006
    Co-Authors: Timea Csak, Anikó Folhoffer, Andrea Horváth, Judit Halász, Csaba Diczházi, Zsuzsa Schaff, Ferenc Szalay
    Abstract:

    A 35-year-old female patient presented with the following symptoms of Holmes-Adie Syndrome: photophobia, enlargement of the left pupil unresponsive to light, Achilles areflexia. The pilocarpine test was positive. No tumor or other neurological abnormality was found. She had a 19-year history of autoimmune hepatitis. Flares up were observed following each 3 deliveries. At age of 31 she presented with diarrhea and weight loss. Abdominal tumor was detected by ultrasound. The surgically removed tumor was histologically a benign mesenteric multicystic lymphangioma. Simultaneously, celiac disease was diagnosed. Gluten-free diet resulted in a significant improvement of celiac disease, but not of autoimmune hepatitis. Autonomic neuropathy was proven by standard cardiovascular tests. The patient was a homozygous carrier for HLA DQ2 antigen characteristic for celiac disease and heterozygous for HLA DR3 B8 frequent in autoimmune liver diseases. Our novel observation on association of Holmes-Adie Syndrome with autoimmune hepatitis and celiac disease is suggestive for a common immunological background for all three entities present in a patient with mesenteric multicystic lymphangioma.