Fugimoto Fernando, Ghanem Ramon Coral, Monteiro Mário Luiz Ribeiro
Clínica Oftalmológica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Arq Bras Oftalmol. 2005 May-Jun;68(3):381-4. doi: 10.1590/s0004-27492005000300020. Epub 2005 Jul 26.
Lyme disease is a multisystemic disorder caused by Borrelia burgdorferi spirochete, transmitted by ticks. Mainly described in the northern hemisphere and rarely in Brazil. The purpose of this report is to describe a patient with Lyme disease who developed bilateral tonic pupil as the only remaining sign. A 13-year-old female with Lyme disease, presented with bilateral peripheral facial and oculomotor paralysis. After recovery from neurological abnormalities the patient sustained anisocoria, reduced fotomotor reflex, less than normal amplitude of accommodation, tonic pupil constriction for near objects and slow redialation in both eyes. Dilute 0.1% pilocarpine test was positive in both eyes, confirming the suspicion of bilateral tonic pupil. This is the first case report of bilateral tonic pupil caused by Lyme disease.
莱姆病是一种由伯氏疏螺旋体引起的多系统疾病，通过蜱虫传播。主要在北半球被描述，在巴西很少见。本报告的目的是描述一名患有莱姆病的患者，该患者出现双侧强直性瞳孔作为唯一残留体征。一名13岁患有莱姆病的女性，表现为双侧周围性面瘫和动眼神经麻痹。从神经异常恢复后，患者持续存在瞳孔不等大、光反射减弱、调节幅度低于正常、双眼近物强直性瞳孔收缩和缓慢散大。双眼稀释0.1%毛果芸香碱试验均为阳性，证实了双侧强直性瞳孔的怀疑。这是首例由莱姆病引起的双侧强直性瞳孔病例报告。
