Adie's tonic pupil as a manifestation of Sjögren's syndrome


We here report two cases of Adie's tonic pupil, associated with clinical sensory polyneuropathy and Sjögren's syndrome, in one of whom it actually heralded the onset of the syndrome. Electrophysiology studies indicated absent H reflexes but normal peripheral nerve conductions, thus suggesting an involvement of the dorsal roots or spinal ganglion that would be in line with previously published reports of dorsal ganglionitis as the primary neuropathological lesion in Sjögren's syndrome. We suggest that all cases of tonic pupils should be screened for polyneuropathy and Sjögren's syndrome.


Descriviamo qui due casi di pupilla tonica associati con una polineuropatia sensitiva clinica e sindrome di Sjögren. Gli studi elettrofisiologici documentavano un'assenza dei riflessi H con conduzioni periferiche conservate, e suggerivano una lesione a livello delle radici dorsali o del ganglio spinale, come riscontrato nei rari studi neuropatologici dimonstranti ganglionite dorsale in corso di sindrome di Sjögren.

Suggeriamo che tutti i casi di pupilla tonica isolata siano esaminati per polineuropatia e sindrome di Sjögren.

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Vetrugno, R., Liguori, R., Cevoli, S. et al. Adie's tonic pupil as a manifestation of Sjögren's syndrome. Ital J Neuro Sci 18, 293–295 (1997).

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Key Words

  • Adie's tonic pupil
  • Sjögren's syndrome
  • Polyneuropathy