Ross Syndrome is a rare autonomic disorder.

Probable mechanism: limited autonomic ganglioneuropathy


Classic triad:

(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.

To read more or access our algorithms and calculators, please log in or register.