Argyll robertson syndrome (spinal miosis)

General: Caused by syphilis or, rarely, 616i84g epidemic encephalitis; disseminated sclerosis; diabetes; brain tumor; syringomyelia; syringobulbia; chronic alcoholism; injury; encephalitis lethargic a, Guillain-Barr syndrome, Lyme disease, multiple sclerosis, polyarteritis nodosa, and sarcoidosis have been associated with this condition.

Ocular: No direct or consensual pupil reaction to light but to normal accommodation (except in terminal stages, when pupil is fixed to all stimuli); pupil contraction with eserine but poor dilation with atropine; miosis (generally); irregular pupil; occurs unilaterally and bilaterally; anisocoria or discoria frequent.

Clinical: Syphilis of central nervous system; general paresis; tabes dorsalis.

Lebensohn JD. The Argyll Robertson pupil. Am J Ophthalmol

Magalini SI, Scrascia E. Dictionary of Medical Syndromes, 2nd ed. Philadelphia: JB Lippincott, 1981.

Miller NR, ed. Walsh and Hoyts Clinical Neuro-Ophthalmology, vol. 5, part 1, 4th ed. Baltimore: Williams & Wilkins, 1995.

Poole CJM. Argyll Robertson pupils due to neurosarcoidosis: evidence for site of lesion. Br Med J 1984; 289:356.

Robertson DA. Four cases of spinal miosis: with remarks on the action of light on the pupil. Edinburgh Med J 1869; 15:487.