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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. If the right side of the neck is subjected to a painful stimulus, the right pupil dilates (increases in size 1-2mm from baseline).
The ciliospinal center (also known as Budge's center [1]) is a cluster of [citation needed] pre-ganglionic sympathetic neuron cell bodies located in the intermediolateral cell column (of the cornu laterale) at spinal cord segment (C8: Anatomic variation) T1-T2 [2]
The SCG receives pre-ganglionic sympathetic afferents from the ciliospinal center which synapse in the ganglion. Post-ganglionic efferents then leave the SCG and join the internal carotid nerve plexus of the internal carotid artery, accompanying first this artery and subsequently its branches to reach the orbit and ultimately innervate the dilator pupillae muscle to mediate pupillary dilatation.
The pupillary reflex results in the pupil constricting (left) and dilating (right) These include the pupillary light reflex and accommodation reflex . Although the pupillary response , in which the pupil dilates or constricts due to light is not usually called a "reflex", it is still usually considered a part of this topic.
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Adie syndrome is a fairly common, benign, idiopathic neuropathy that selectively affects the ciliary ganglion and the spinal cord neurons involved in deep tendon reflex arcs. It usually develops in middle age, although it can occur in children. A variant of Adie syndrome, Ross syndrome, affects sweating as well.