PHOTIC SNEEZE REFLEX (ACHOO SYNDROME)

Click to edit Master subtitle style

5/14/12

Click icon to add picture

5/14/12

www.scientifi camerican.co

INTRODUCTION
n

Sneeze is an involuntary and forceful reflex expulsion of air through the nose and mouth as a result of irritation of the mucous membrane lining the nasal cavity (Oxford medical dictionary, 10th edition). It is mainly as a result of certain irritants such as dust, pepper, strong smells, common cold, allergies, light source etc

5/14/12

TYPES OF SNEEZE REFLEX

n n n n n

Depending on the cause, there are various types of sneeze reflex: Photic sneeze reflex Allergic sneeze reflex Snatiation reflex Sneezing induced by sexual ideation or orgasm

5/14/12

PHOTIC SNEEZE REFLEX

n

It is colloquially referred to as sun sneezing (Everett,1984) It is described as a condition of uncontrollable sneezing by dark-adapted individuals in response to numerous stimuli such as looking at a bright light source or periocular injection (Peroutka et. al,1984. Abramson D.C,1995)

It is an autosomal dominant trait which 5/14/12 affects about 18-35% of the population

It is also known as ACHOO syndrome (Pagon et. al,1978) n A-autosomal dominant n C-compelling n H-helion O-ophthalmic n O-outburst n The gene responsible for this trait has not yet been Identified but if one copy of it is present in a parent, the children have a 50% chance of inheriting it (Eriksson et. al, 5/14/12 2010)
n

BRIEF HISTORY
n

Aristotle

first

mentioned

about

this

phenomenon(Problems, book XXXIII) and wondered why the heat from the sun provoked sneezing and guessed that the heat from the sun on the nose was probably responsible.
n

However, the tear seeping from the eyes to the nose through the nasolacrimal duct was
5/14/12

said to be responsible(Francis Bacon,17th

MECHANISM OF SNEEZING
n

When the nasal mucosa is stimulated it triggers the release of histamines which irritates nasal nerve cells Signals are sent to the brain through trigeminal nerve network The brain then activates the pharyngeal and tracheal muscles which elicits sneezing

5/14/12

MECHANISM OF PHOTIC SNEEZE

being forwarded which includes;

Direct cause is not known but hypothesis have Light leads to lacrimation which drains via the nasolacrimal duct to the nasal mucosa Parasympathetic summation whereby

parasympathetic neuronal output to one organ is accompanied by parasympathetic output to other organs
5/14/12

MECHANISM OF PHOTIC SNEEZE

n

It is also believed that it is as a result of crossed signals in the brain due to proximity of the optic and trigeminal nerve Intraorbital stimulation of the trigeminal nerve and increased ocular sensitivity to light in some people

5/14/12

SIGNS AND SYMPTOMS

n

Uncontrollable sneezing in response to light (photic sneeze) Response to periocular injection; which occurs during eye surgery whereby the patient requires an anaesthetic into the eyeball (Abramson D.C,1995).

5/14/12

DIAGNOSIS
n

Observation of individuals sneezing patterns and that of close relatives Because it is an autosomal dominant trait, a child is 50% likely to be a photic sneezer if one of his or her parent is

5/14/12

RISKS
n

n n

Disease transmission via the spread of microbes suspended in the droplets expelled by a sneeze Vehicle operation leading to accident of victims Medical procedures especially with patients under propofol sedation who undergo periocular or retrobulbar injection. A sneeze often occurs on insertion of a needle in or around the eye which may lead to eye injuries

5/14/12

PREVENTIVE MEASURES
There is currently no definitive cure to fits brought about by photic sneeze but it can be combated by the following measures; n Drug use Antihistamines used in treating rhinitis Homeopathy Herbal medicine- (elderberry, nettles) n Non drug use Wearing of sunglasses Polarised goggles
n
5/14/12

PROGNOSIS
n

The ACHOO syndrome is a condition that occurs for life and thus there is no evidence that it in any way affects a persons life span.

5/14/12

CONCLUSION
n

The photic sneeze reflex is not a disease but a phenomenon which is of no dangerous effect on its own; People with it are advised not to operate automobiles like cars, planes etc and if they should, wearing of sun shades is vital.

5/14/12

REFERENCES
n

Abramson,D.C(1995).Sudden unexpected sneezing during the insertion of peribulbar block under propofol sedation. Journal of anaesthesia,8:740-743. Eriksson et al ,(2010). Web based participant driven studies yield novel genetic associations for common traits Everett, H.C(1964). Sneezing in response to light. JAMA, 483-490

5/14/12

REFERENCES, contd
n

Karen Schrock (2008). Looking at the sun can trigger sneeze. Scientificamerican.com Semes, L.P., Amos, J.F. and Waterbor, J.W. (1995). The Photic Sneeze Response: Descriptive Report of a Clinic Population. Journal of American optometry. Whitman, B.W, and R.J Parker (1993). The Photic Sneeze Reflex. Neurology, 5:868-871.
5/14/12

Click icon to add picture

5/14/12