1.Unilateral tonic pupil in spinocerebellar ataxia without brainstem atrophy
Shiroh Miura ; Hiroshi Kida ; Sumire Nishimura ; Kazuhito Noda ; Toru Urano ; Seiyo Honda ; Mitsuyoshi Ayabe ; Hisamichi Aizawa ; Takayuki Taniwaki
Neurology Asia 2007;12(1):131-133
We report a case of unilateral tonic pupil in spinocerebellar ataxia without brainstem atrophy in a 42-
year-old man. On neurological examination, he showed cerebellar symptoms and unilateral tonic pupil.
Deep tendon reflexes were normal except for brisk patellar tendon reflexes. Brain MRI demonstrated
cerebellar atrophy only. There was neither orthostatic hypotension nor bowel and bladder failure. The
right pupil constricted from 5.0 mm to 1.7 mm 60 minutes after 0.125% pilocarpine administration,
whereas the left pupil did not change, remaining at 3.7 mm. Although it is not proven that tonic pupil
is causally related to spinocerebellar ataxia, physicians must remain aware of spinocerebellar ataxia
as a disease that can demonstrate tonic pupil.
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