Horner's syndrome with ipsilateral accommodative paresis

In a 12-year-old girl with Horner's syndrome and an ipsilateral accommodative paresis, intravenous administration of edrophonium chloride improved the accommodative defect on several occasions, which suggested a possible relationship to myasthenia gravis. Additional testing of the accommodative paresis revealed some of the characteristics of Adie's syndrome and suggested a relationship to pupil-sparing Adie's syndrome.