Light-induced sneezing and Argon effects

John Logsdon jlogsdon at
Mon Oct 21 18:59:29 EST 1996

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Collie et al. (1978) described a 'disorder' characterized by nearly uncontrollable paroxysms of sneezing provoked in a reflex
fashion by the sudden exposure of a dark-adapted subject to intensely bright light, usually sunlight. The number of successive
sneezes was usually 2 or 3, but could be as many as 43. The 4 authors were the probands of the 4 families they reported. Several
instances of male-to-male transmission were noted. Sneezing in response to bright light was said by Peroutka and Peroutka
(1984) to be a common yet poorly understood phenomenon. Photic sneeze reflex was suggested as the appropriate designation
by Everett (1964), who found it in 23% of Johns Hopkins medical students. In a poll of 25 neurologists at Johns Hopkins,
Peroutka and Peroutka (1984) found the phenomenon in 9, but only 2 of the respondents knew that such a specific reflex exists.
The Peroutkas (father and daughter) reported the reflex in 3 generations of their family: grandfather, the father (the proband), his
brother and his daughter. The index subject (S.J.P.) invariably sneezes twice when he moves from indoors into bright sunlight.
Lewkonia (1969) described sneezing as a complication of slit lamp examination. Katz et al. (1990) found light-induced sneezing
in 5 of 19 patients with nephropathic cystinosis (219800). This was presumably related to the crystal deposition in the cornea.
Lerner (1991) took Hunter (1990) to task for referring to the photic sneeze reflex as a 'comic syndrome.' He cited reports by
Beckman and Nordenson (1983), Forrester (1985), Morris (1987), and Lang and Howland (1987), in addition to those already
cited here. Benbow (1991) reported that he had suffered from photic sneezing for over 20 years and having just learned of its
existence found that the 'symptoms are more easily tolerated if you can put a name to them, even if that produces only an illusory
understanding of their significance.' He commented on the potential hazards of photic sneezing if it occurs while one is driving a
car on a sunny day. He said that he found that 'sudden exposure to sunlight when emerging from a road tunnel of sufficient
length is sure to induce a sneeze.' Furthermore, 'driving through sunlit gaps in otherwise dense forest or past blocks of buildings
can bring on a sneeze.'  

Duncan (1995) pointed out public awareness of the ACHOO syndrome is much more widespread than one might guess, to the
point that it has entered into the popular wisdom conveyed to preschoolers. In a best-selling children's book by Berenstain and
Berenstain (1981), Papa and Mama bear are taking sister bear and brother bear to their pediatrician, Dr. Grizzly, for a check-up.
The cubs are expressing their apprehension about the possibility of injections when Papa bear suddenly cuts loose with an
explosive sneeze. 'Bless you!' said Mama.' 'It's just this bright sunlight,' sniffed Papa. 'I never get sick.'  


1. Beckman, L.; Nordenson, I. : 
       Individual differences with respect to the sneezing reflex: an inherited physiological trait in man?.
       Hum. Hered. 33: 390-391, 1983. 
       MEDLINE UID : 84184366

2. Benbow, E. W. : 
       Practical hazards of photic sneezing. (Letter) Brit. J. Ophthal. 75: 447 only, 1991.

3. Berenstain, S.; Berenstain, J. : 
       The Berenstain Bears Go to the Doctor. New York: Random House (pub.) 1981.

4. Collie, W. R.; Pagon, R. A.; Hall, J. G.; Shokeir, M. H. K. : 
       ACHOO syndrome (helio-ophthalmic outburst syndrome). Birth Defects Orig. Art. Ser. XIV(6B): 361-363,

5. Duncan, R. : Personal Communication. Los Angeles, Calif., 2/1/1995.

6. Everett, H. C. : 
       Sneezing in response to light. Neurology 14: 483-490, 1964.

7. Forrester, J. M. : 
       Sneezing on exposure to bright light as an inherited response. Hum. Hered. 35: 113-114, 1985. 
       MEDLINE UID : 85181229

8. Hunter, K. M. : 
       An N of one: syndrome letters in the New England Journal of Medicine. Perspect. Biol. Med. 33:
       237-251, 1990.

9. Katz, B.; Melles, R. B.; Swenson, M. R.; Schneider, J. A. : 
       Photic sneeze reflex in nephropathic cystinosis. Brit. J. Ophthal. 74: 706-708, 1990.

10. Lang, D. M.; Howland, W. C., III : 
       Solar sneeze reflex. (Letter) J.A.M.A. 257: 1330-1331, 1987.

11. Lerner, D. L. : 
       Letter to the editor. Perspect. Biol. Med. 34: 469-470, 1991.

12. Lewkonia, I. : 
       An infrequent response to slit lamp examination. Brit. J. Ophthal. 53: 493-495, 1969.

13. Morris, H. H., III : 
       ACHOO syndrome: prevalence and inheritance. Cleveland Clin. J. Med. 54: 431-433, 1987.

14. Peroutka, S. J.; Peroutka, L. A. : 
       Autosomal dominant transmission of the 'photic sneeze reflex.'. (Letter) New Eng. J. Med. 310: 599-600,
       MEDLINE UID : 84117440


       View Clinical Synopsis Entry 


Victor A. McKusick : 6/4/1986 


carol : 2/20/1995 
davew : 7/19/1994 
mimadm : 3/11/1994 
supermim : 3/16/1992 
carol : 9/18/1991 
carol : 7/22/1991 

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