The phenomenon of benign areflexia

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Abstract
The H reflex and other electric phenomena of the ankle jerk were studied in 2 patients considered to have benign areflexia. One was a male with the classical picture of Holmes-Adie syndrome and the second, a female with an atypical picutre of pupillotonia (Adie pupil), profound areflexia, and dystrophia myotonica. An example of a 3rd patient with Holmes-Adie syndrome and partial anhidrosis may relate this syndrome to generalized disorders of the autonomic nervous system. It was concluded that benign areflexia is not caused by a lesion of the fusimotor system or of stretch receptor afferents but is more than likely the result of dysfunction in the presynaptic terminals of group Ia dorsal root fibers or else to a progressive degeneration of local segmental neuropil excitatory to the alpha motoneurons. The latter possibility is favored because these interneurons, possibly having their ontological origins in common with the neurons of the peripheral autonomic system, would therefore be more constitutionally disposed to share in a degenerative disorder of that system.