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PubMed1979

[Current educational practices with multiply handicpped pupils -- a problematic approach in special education (author's transl)].

The curricula of schools for the physically handicapped have, as yet, been influenced too much by those of regular schools. Which is why at special schools, too, the primary focus of all educational and therapeutic measures is placed on a qualification of the pupils. Also those pupils who, as a result of the severity of their disability, will not be able to enter vocational training are instructed on the basis of curricula modelled for the non-disabled. The purpose of the following article is to introduce this problem complex which has been present for years but not yet received satisfactory solutions. It is hoped that the described experiences gained with the three groups of pupils will stimulate the discussion.

Child↗
PubMed1978

Pharmacological studies of the pupils in familial amyloid polyneuropathy.

Pharmacological studies of the pupils of 7 patients with familial amyloid polyneuropathy (FAP) were performed in order to demonstrate the site of the lesion. Supersensitivity to 1.25% epinephrine was observed frequently, but not to 2.5% methacholine. The lesions of the sympathetic nervous system, judging from the epinephrine and tyramine tests, were regarded as preganglionic in 2 patients and postganglionic in 4. Among 3 patients reexamined six months later, 1 had developed signs of sympathetic postganglionic disturbance and another showed a peripheral parasympathetic disturbance associated with progress of a sympathetic preganglionic disturbance. From these results it was suggested that in FAP, sympathetic abnormalities involve the pupils more often than parasympathetic disturbances, and pharmacological studies can detect the autonomic dysfunction before it becomes clinically apparent.

Adult↗
PubMed1978

Cholinergic supersensitivity of the iris sphincter in Adie's tonic pupil.

In patients with unilateral Adie's syndrome, we compared the relative supersensitivity of the tonic pupil to methacholine hydrochloride (Mecholyl 2.5%) and pilocarpine 0.125%. We tested a large series of patients and photographed the pupils before and 30 minutes after the eyedrops. In a group of 36 patients, Mecholyl was positive in 64% of the tests; and in a group of 20 patients, pilocarpine 0.125% was positive in 80% of the tests. Eight patients who failed to show supersensitivity with Mecholyl were tested with pilocarpine and five of the eight were shown to be supersensitive. We concluded that pilocarpine, in this concentration is not only an adequate substitute for Mecholyl 2.5%, but is a more sensitive testing substance in unilateral cases, simply because it has a slightly stronger miotic action.

Adie Syndrome↗
PubMed1979

Atropine versus glycopyrrolate. A study of intraocular pressure and pupil size in man.

Following control observations of intraocular pressure and pupil size, in doses suitable for pre-anaesthetic medication, glycopyrrolate (0.004 mg/kg) and atropine (0.01 mg/kg) were given intramuscularly to healthy volunteers in a randomised, cross-over fashion. No significant change in either intraocular pressure or pupil size was noted 45 min after drug administration.

Adult↗
PubMed1978

Waardenburg syndrome with a fixed dilated pupil.

An unusual case of Waardenburg syndrome associated with a detailed and fixed pupil of the lighter eye is described. Pharmacological investigations were performed to localise the site of the pupillary lesion. A lack of cholinergic reactivity was demonstrated, possibly due to congenital agenesis of the sphincter pupillae. Sympathetic activity was not impaired. Spiral ganglion agenesis and midline congenital anomalies are common features in Waardenburg syndrome. These lesions as well as the fixed dilated pupil might be due to an embryonal inductive failure.

Abnormalities, Multiple↗
PubMed1976

Hereditary sensory neuropathy and tonic pupils.

The clinical features of two siblings with both hereditary sensory neuropathy and bilateral tonic pupils are described. Other neurologic disorders associated with tonic pupils are reviewed. Our patients appear to represent a unique instance of the association of disorders that primarily affect the ciliary and dorsal root ganglia.

Adult↗
PubMed1979

Using color substitution pupil response to expose chromatic mechanisms.

It is well known that pupillary threshold shows a scotopic spectral behavior, even for foveal stimuli. However, when two scotopically balanced fields at different wavelengths are alternated, the pupil shows a constriction response at each transition, exposing innervation from chromatic mechanisms. Using a suitable model for pupillary innervation, this substitution response is systematically studied for different wavelengths and radiant power levels to yield (within the accuracy of the assumptions of the model) spectral threshold curves for the chromatic mechanism as indicated by the pupil. Four mechanisms have thus been identified, having peak sensitivities near 450, 525, 580, and 495 nm. We propose that these represent the blue, green, red and scotopic mechanisms as maintained before the level of the lateral geniculate body.

Color Perception↗
PubMed1979

Head injury and the dilated pupil.

The significance of the dilated pupil in head injury is discussed. History of this condition and its possible mechanisms are described. Three patient reports are presented with unilateral dilated pupil. The literature on the subject is reviewed. Finally, the diagnostic steps which may be taken to differentiate direct third nerve injury from expanding mass lesion are suggested.

Adult↗
PubMed1977

Tonic pupils with acute ophthalmoplegic polyneuritis.

Two patients with the symmetrical ophthalmoplegic variant of acute idiopathic polyneuritis (Fisher's syndrome) developed bilateral dilated pupils with cholinergic supersensitivity and light-near dissociation (tonic pupils), indicating involvement of the postganglionic parasympathetic neuron within the orbit. Supranuclear eye movement dysfunction also was present, indicated by relative levator sparing in both patients and by preservation of Bell's phenomenon in 1 patient despite paralysis of voluntary upward gaze. The lesions that produce the eye signs of ophthalmoplegic polyneuritis are not necessarily restricted to the cranial nerve trunks. The present cases support a relationship between the ophthalmoplegic variant of the Guillain-Barré syndrome and acute postinfectious encephalomyelitis (brainstem encephalitis) on the one hand, and idiopathic autonomic neuropathies such as the Holmes-Adie syndrome and pandysautonomia on the other.

Adult↗
PubMed1978

Secular trends in height and weight of Japanese pupils.

In the city of Sendai, the height and weight of pupils at the ages of 11.5 to 12.0 years and 14.5 to 15.0 years have been measured in every spring and autumn since 1936. The analyses of the data summarized for 40 years revealed reduction in physique of the pupils in early 1940's and a marked growth acceleration in late 1940's till 1960's, followed by reduction in secular growth rates in late 1970's. The reduction is more prominent in the core part of the city. The results are compared with those from two extremes in Japan, i.e., megalopolitan areas and remote areas, and also those from European and North American countries.

Adolescent↗
PubMed1978

[Value of the discover mental defects for the pathogenesis of psychosocial disorders by normal pupils--a study about patients of a neuropsychiatric station for children (author's transl)].

200 normal pupils were tested, to discover mental defects by HAWIK IQ less than or equal to 84. All tested pupils were treated stationary for psychosocial disorders. 37 mental defects were demonstrable. The mental defect gets the third rank in the quantity of pathological causes for psychosocial disorders. The atmosphere reactive disorders head the list followed by partial psychological disorders of performance. The early recognition of these defects is of necessity in medical, psychological and pedagogic view.

Child↗
PubMed1979

Marcus Gunn pupil in a possible case of unilateral retinitis pigmentosa.

A possible case of unilateral retinitis pigmentosa (RP) is reviewed. The electrodiagnostic and clinical findings are discussed, with perspective given to alternative diagnoses. A review of the literature is included to show the controversy which clouds a positive diagnosis of unilateral RP. A co-existing Marcus Gunn pupil is defined and discussed in relation to unilateral RP-like processes.

Diagnosis, Differential↗
PubMed1978

An increased effect of pilocarpine on the pupil by application of the drug in oil.

In healthy volunteers pilocarpine in an oily solution had a greater degree and duration of effect on the pupil than the same amount of drug given in aqueous solution. Blue- and brown-eyed subjects had similar degrees of miosis, but the time taken to reach peak effects was longer with the latter. It can be concluded that eye drops made with an oily solvent may provide an improvement in the treatment of glaucoma with pilocarpine.

Adolescent↗
PubMed1979

Acute aphakic pupil block glaucoma: an alternative surgical approach.

In a series of 7 cases of acute aphakic pupil block glaucoma a surgical approach designed to break adhesions between the iris and the anterior hyaloid face was uniformly successful. Reasons for the success of the method are discussed and comparisons made with other surgical approaches.

Acute Disease↗
PubMed1977

Argyll-Robertson-like pupils in the neural type of Charcot-Marie-Tooth disease.

The authors report of Argyll-Robertson-like pupils in three patients presenting the neural type of Charcot-Marie-Tooth (CMT) disease with peroneal muscular atrophy. Up to now the light-near dissociation had been reported in the hypertrophic variety of CMT disease. Stress is laid upon the fact that the presence of the light-near dissociation in patients with CMT disease does not help in clinically differentiating the neural from the hypertrophic type of this disease.

Charcot-Marie-Tooth Disease↗