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Tonic pupils in neurosyphilis

Neuro-ophthalmology Unit, Division of Neurology and the Playfair Neuroscience Unit, Toronto Western Hospital, Departments of Medicine and Ophthalmology, University of Toronto, Toronto, Ontario, Canada.

Of 60 patients with tonic pupils, 29 had serologic tests for syphilis. Five patients had positive blood serology and confirmatory tests; four had other manifestations of neurosyphilis and positive CSF serology. All seropositive patients had bilateral tonic pupils with light-near dissociation and denervation hypersensitivity. Of the 10 tonic pupils, only 1 was miotic and 1 dilated. Although tonic pupils tend to become small and bilateral, they should be distinguished readily from Argyll Robertson pupils, which react briskly, not tonically, to near stimuli. Patients with bilateral tonic pupils should have serologic tests for syphilis.

Address correspondence and reprint requests to Dr. Sharpe, Division of Neurology, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8.

Supported by Medical Research Council of Canada grants ME5509 and MT5404 and by the Alberta Heritage Research Foundation. Dr. Fletcher is an Alberta Heritage Research Fellow in Neuro-ophthalmology.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Accepted for publication June 3, 1985.

This article has been cited by other articles:

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