[Differential diagnosis and therapy in Adie's syndrome]

In general, Adie's syndrome does not represent a serious diagnostic problem. In cases of cerebrospinal syphilis the Argyll-Robertson phenomenon or even absolute pupillary rigidity will be observed. Positive syphilis reactions will clarify these cases. The erroneous diagnosis of brain tumour may arise because of anisocoria. However, if pupillotonia can be ascertained by means of conjunctival instillation of drugs no further invasive diagnostics will be necessary. In some cases of Adie's syndrome concomitant emotional instability may be present. This dysautonomic reaction type of personality will hardly ever be confounded with the psychological disturbances encountered in brain tumours. Therapy is restricted to symptomatic measures. Pupillotonia can be influenced by strychnine and thymoxamine. Headache and facial neuralgia respond to the usual therapeutic schemes. Sweating disorder cannot be influenced. Neuropharmacological treatment may become necessary in periods of acute emotional disturbance.