In parenchymatous neurosyphilis, the CSF reaginic and serum treponemal tests are reactive, and CSF typically has lymphocytic pleocytosis and elevated protein. Conveniently, a popular mnemonic to remember Argyll Robertson pupils is that, just like prostitutes, they "accommodate but do not react". In neurosyphilis, most symptoms and signs, except for Argyll Robertson pupil, are nonspecific, so that diagnosis relies heavily on a high index of clinical suspicion. J.: Pseudo-Argyll-Robertson pupils with absent tendon reflexes Benign disorder simulating tabes dorsalis, Brit. I could not observe any contraction of either pupil under the influence of light, but, on accommodating the eyes for a near object, both pupils contracted. Named after Douglas Argyll Robertson (1837–1909), a Scottish surgeon and ophthalmologist, who first described this condition in mid-1860s in patients with neurosyphilis.Īrgyll Robertson pupils are also sometimes called "prostitute's pupils" because of their association with late neurosyphilis. 1869 Argyll Robertson published his ocular clinical findings of four patients with a spinal disease, now known to be neurosyphilis, in the Edinburgh Medical Journal. The exact anatomical lesion behind this phenomenon is unknown but is thought to be caused by bilateral damage of the pretectal nuclei in the midbrain. When seen in these non-syphilitic etiologies, the pupil is termed ' pseudo-Argyll Robertson pupil' 3. Argyll Robertson Pupil Lateral branches: Gray rami to join cervical spinal It is a disorder in a patient of neurosyphilis due to lesion nerve to arterial. It is a highly specific sign of late neurosyphilis, however can also occur in diabetic neuropathy, multiple sclerosis, alcoholic midbrain degeneration, and stroke 2,3. Argyll Robertson pupil is usually bilateral and presents as bilaterally miotic and irregular pupils, which constrict briskly with accommodation but do not react to bright light therefore displaying light-near dissociation 1. This chapter describes the assessment of pupil function and the occurrence of pupil disturbance in disorders of the autonomic nervous system.
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