[A rare case of Holmes-Adie syndrome in a 60-year-old patient with a chronic cough cured in a laryngological way]. / Rzadki przypadek zespolu Holmesa-Adiego u szescdziesiqcioletniej chorej leczonej laryngologicznie z powodu przewleklego kaszlu.

UNLABELLED: The case of a 60-year-old woman with a chronic dry cough which lasted for 4 years is presented. The patient underwent thorough diagnostics. Clinical examination and laboratory tests excluded pathology in the upper and lower airways, which could have been the cause of the cough. An ophthalmological examination revealed a tonic pupil with dissociation of a close light. Neurological findings showed reduced deep tendon reflexes. The above mentioned findings were accompanied by abnormalities of autonomic function, such as orthostatic hypotension and bradycardia while performing the Valsalva maneuver during respiration. Both clinical examination and diagnostic tests made it possible to establish a rare case of Holmes-Adie syndrome. CONCLUSION: The presence of a dry chronic cough occurring in a patient without pathology in the upper and lower airways indicates the necessity for ophthalomlogical and neurological examination in order to confirm the existence of Holmes-Adie syndrome.

[Bilateral Adie's syndrome in child]. / Obustronny zespól Adiego u dziecka.

Bilateral Adie's syndrome is characterized by the presence of a tonic pupil connected with accommodation problems. Very often, it coexists with latent hypermetropia, corneal hyposensivity. Typical signs are weakened tendons reflexes. We present the 8 years old girl with bilateral Adie's syndrome, which was the cause of school problems.

Management of Adie syndrome.

In most instances the patient with pupillotonia presents with under accommodation in the affected eye. An unusual case of Adie's pupil with ciliary spasm is discussed. As a result of the unpredictable accommodative response, the necessity of evaluating and prescribing for binocular balance is underscored. Periodic reevaluation of accommodation in relation to symptomatology is emphasized.