Ross syndrome plus: beyond horner, Holmes-Adie, and harlequin.

Abstract

Ross syndrome is an uncommon disorder characterized by the triad of segmental anhidrosis, hyporeflexia, and tonic pupils. The authors describe the clinical findings of five patients with Ross syndrome and detail the results of their pharmacologic and autonomic testing. In four patients, the classic findings of Ross syndrome were accompanied by Horner's syndrome. Other symptoms of dysautonomia were also common. These findings suggest that Ross syndrome is a dysautonomic condition of varying expression resulting from a generalized injury to ganglion cells or their projections.