Ciliospinal reflex

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The ciliospinal reflex (pupillary-skin reflex) consists of dilation of the ipsilateral pupil in response to pain applied to the neck, face, and upper trunk.[1] If the right side of the neck is subjected to a painful stimulus, the right pupil dilates (increases in size 1-2mm from baseline).[1]

This reflex is absent in Horner's syndrome and lesions involving the cervical sympathetic fibers.[1] The enhanced ciliospinal reflex in asymptomatic patients with cluster headache is due to preganglionic sympathetic mechanisms.[1]

It was first described in 1852 by Budge.[2]


  1. 1.0 1.1 1.2 1.3 Tripathy, Koushik; Simakurthy, Sriram; Jan, Arif (8 May 2022). "Ciliospinal Reflex". StatPearls Publishing. Archived from the original on 30 June 2023. Retrieved 14 May 2023. {{cite journal}}: Cite journal requires |journal= (help)
  2. Reeves, Alexander G.; Posner, Jerome B. (1 December 1969). "The ciliospinal response in man". Neurology. 19 (12): 1145–1145. doi:10.1212/WNL.19.12.1145. ISSN 0028-3878. Archived from the original on 2 June 2018. Retrieved 14 May 2023.