Asymptomatic autonomic and sweat dysfunction in patients with Adie's syndrome

A study was conducted to determine by using noninvasive tests whether autonomic dysfunction occurs in patients with Adie's syndrome. Eighteen consecutive patients with Aide's syndrome prospectively underwent a standardized battery of five noninvasive tests of autonomic function, including three that predominantly reflected parasympathetic function and two that predominantly reflected sympathetic function. Eight of these patients additionally underwent thermoregulatory sweat testing. Of the 18 patients 10 (56%) had no abnormal autonomic test results, 5 (28%) had one abnormal result, 2 (11%) had two abnormal results, and 1 (6%) had three abnormal results. None of the patients had more than three abnormal results. Tests that predominantly reflected parasympathetic function produced abnormal results more frequently than those that predominantly reflected sympathetic function. Three of eight (38%) patients who underwent thermoregulatory sweat testing showed abnormal patterns of sweating. Although abnormal autonomic and sweat functions are not uncommon in patients with Aide's syndrome, the abnormalities are mild and are generally unassociated with symptoms of dysautonomia. Such abnormalities have little clinical significance but may be important from a nosologic point of view.