Journal of Neurology

, Volume 239, Issue 4, pp 231–234 | Cite as

Tonic pupil, areflexia, and segmental anhidrosis: two additional cases of Ross syndrome and review of the literature

  • Michael Weller
  • Helmut Wilhelm
  • Norbert Sommer
  • Johannes Dichgans
  • Horst Wiethölter
Original Communications


Two patients are described with the triad of tonic pupil, hyporeflexia and segmental anhidrosis (Ross syndrome). Only 18 cases of this syndrome have been reported in the literature so far. While tonic pupil and reduced sweating can be attributed to the affection of postganglionic cholinergic parasympathetic and sympathetic fibres projecting to the iris and sweat glands, respectively, the pathogenesis of diminished or lost tendon jerks remains obscure. To identify the characteristic clinical features, the previous cases of Ross syndrome are reviewed. Recent evidence of subclinical disturbances of sweating in most patients with Adie's syndrome, i.e. tonic pupil and areflexia, casts doubt on the nosological concept of Ross syndrome as a distinct clinical entity.

Key words

Ross syndrome Adie's (tonic) pupil Anhidrosis 


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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Michael Weller
    • 1
  • Helmut Wilhelm
    • 2
  • Norbert Sommer
    • 1
  • Johannes Dichgans
    • 1
  • Horst Wiethölter
    • 1
  1. 1.Neurologische UniversitätsklinikTübingenGermany
  2. 2.Abteilung für NeuroophthalmologieUniversitäts-AugenklinikTübingenGermany

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