Neurological Sciences

, Volume 31, Issue 5, pp 661–663 | Cite as

Bilateral Holmes–Adie syndrome as an early manifestation of the HIV neuropathy

  • Rudolf Cerny
  • Hanus Rozsypal
  • Pavel Kozner
  • Ladislav Machala
Case Report

Abstract

A 38-year-old HIV-1 infected woman affected with bilateral tonic pupils. Ophthalmologic examination confirmed Holmes–Adie syndrome (HAS), and peripheral distal polyneuropathy, orthostatic hypotension and leg hyperhidrosis were detected on further workup. The HAS can be either idiopathic or associated with neuropathy of various etiology (autoimmune, paraneoplastic and infectious). In our patient, the pupillotonia was the first and early symptom of hitherto unrecognized HIV neuropathy. HAS has been previously observed in association with syphilis, Lyme borreliosis, herpes simplex and parvovirus B19 infection. Our case is the first report of HAS in a case of HIV infection.

Keywords

Holmes–Adie syndrome Tonic pupil Areflexia HIV Polyneuropathy 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Rudolf Cerny
    • 1
  • Hanus Rozsypal
    • 2
  • Pavel Kozner
    • 3
  • Ladislav Machala
    • 4
  1. 1.Department of Neurology, 2nd Medical FacultyCharles University in PraguePragueCzech Republic
  2. 2.Department of Infectious and Tropical Diseases, First Faculty of Medicine, University Hospital BulovkaCharles University in PraguePragueCzech Republic
  3. 3.Department of OphthalmologyUniversity Hospital BulovkaPragueCzech Republic
  4. 4.1st Department of Infectious Diseases, 2nd Faculty of Medicine and Department of Infectious Diseases, Third Faculty of MedicineCharles University in PraguePragueCzech Republic

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