Research Paper
We have studied pupillary responses to parasympathetic and sympathomimetic agents, pupillary cycle time and the electrophysiology of the blink reflex in 18 patients with myotonic dystrophy. The response of the iris to dilute pilocarpine and phenylephrine did not indicate pharmacologic supersensitivity. Pupillary cycle time was prolonged in nine of the 18 patients. Ipsilateral R1 blink reflex latencies were normal in all cases, and bilateral R2 were normal in 16 of the 18 patients. These results do not support either autonomic or brainstem dysfunction in the majority of patients with myotonic dystrophy. In 50% of the patients the results are compatible with smooth muscle involvement of the iris.
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Nemet P, Rock T, Korczyn AD. Ocular movements in myotonic dystrophy.Acta Strabologica 1985;3: 263–267.
Von Noorden G, Thompson H, Von Allen M. Eye movements in myotonic dystrophy. An electro-oculographic study.Invest Ophthalmol 1964;3: 314–324.
Kaplan P, Kaplan C. Blink reflex: review of methodology and its application to patients with stroke syndromes.Arch Phys Med Rehabil 1980;61: 30–33.
Kimura J. Blink reflex for test for brain stem and higher central nervous system function. In: Desmedt JE, ed.New Developments in Electromyography and Clinical Neurophysiology, Vol 3. Basle: Karger, 1973: 602–691.
Miller S, Thompson S. Edge-light pupil cycle time.Br J Ophthalmol 1978;62: 495–500.
Spaide R. Decreased sympathetic stimulation to the pupils in two patients with myotonic dystrophy.Ann Opthalmol 1984;16: 685–688.
Blumen S, Feiler-Ofry V, Korczyn AD. The pupil cycle time in Horner's syndrome.J Clin Neuro-ophthalmol 1986;6: 232–234.
Bourgon P, Pilley SFJ, Thompson HS. Cholinergic supersensitivity of the iris sphincter in Adie's tonic pupil.Am J Ophthalmol 1978;85: 373–377.
Korczyn AD, Laor N. Pharmacological responses of pupillary smooth muscle in myopathies.Israel J Med Sci 1977;13: 134–135.
Saenger A. Ueber myotonische Pupillenbewegung.Neurol Centralbl 1902;21: 837.
Bramwell E, Addis W. Myotonia atrophica.Edinburgh Med J 1913;11: 21–25.
Thompson H, Van Allen M, Von Noorden G. The pupil in myotonic dystrophy.Invest Ophthalmol 1964;3: 325–338.
Avrahami E, Katz A, Bornstein N, Korczyn AD. Computed tomographic findings of brain and skull in myotonic dystrophy.J Neurol Neurosurg Psychiat 1987;50: 435–438.
Zeitthofer J, Rasinger G, Mayr N, Mamoli B. Veranderungen der Hirnstammpotentiale bei dystrophia myotonica.Z EEG-EMG 1986;17: 209–212.
Miller S, Thompson S. Pupil cycle time in optic neuritis.Am J Ophthalmol 1978;85: 635–642.
Sandrini G, Gelmi C, Rossi V, Bianchi PE, Alfonsi E, Paccheti C, Verri AP, Nappi G. Electroretinographic and visual evoked potential abnormalities in myotonic dystrophy.EEG Clin Neurophysiol 1986;64: 215–217.
Katz A, Meites I, Bornstein N, Escher J, Korczyn AD. Cardiac manifestations of myotonic dystrophy.Functional Neurol 1989;4: 355–361.
Martin CN. Edge light pupil cycle time: a quantifiable autonomic reflex.J Neurol Neurosurg Psychiatry 1985;48: 6021.
Meyer E, Navon D, Auslender L, Zonis S. Myotonic dystrophy: pathological study of the eyes.Opthalmologica 1980;181: 215–220.
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Alon, M., Korczyn, A.D. Pupillary responses and blink reflex in myotonic dystrophy. Clinical Autonomic Research 2, 17–19 (1992). https://doi.org/10.1007/BF01824206
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DOI: https://doi.org/10.1007/BF01824206