(1) abnormal sweating (mixed anhidrosis and hyperhidrosis; sudomotor dysfunction)
(2) tonic pupil with unilateral dilatation (Holmes-Adie)
(3) depressed or absent deep tendon reflexes
Anhidrosis may be segmental, widespread or generalized. Compensatory hyperhidrosis and hyperpigmentation (giving a variegated appearance) may be present in areas without anhidrosis.
If the patient has anhidrosis then there is often a well-circumscribed area (island) of preserved sweating within the anhidrotic region.
Other features may include:
(1) fatigue
(2) chronic cough
(3) increased urinary frequency
Some patients are positive for an autoantibody.
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