There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757497 | PMC |
| http://dx.doi.org/10.1136/bcr-2020-237257 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Neurological Insights: Transient Unilateral Relative Afferent Pupillary Defect in the Context of Serotonin Syndrome.
Cureus
December 2024
Internal Medicine, Saint Joseph Hospital-Intermountain Health, Denver, USA.
The pupillary reflex is a complex physiological response involving both the eye and associated neural pathways. Relative afferent pupillary defects (RAPDs) can present due to various underlying pathologies, yet their occurrence in serotonin syndrome has been rarely documented. This report details the case of a 21-year-old non-binary individual with a history of bipolar disorder who presented to the emergency department following a polypharmacy overdose, including significant ingestion of sertraline, aripiprazole, and buspirone.
View Article and Find Full Text PDFIsolated reversible mydriasis was associated with the use of nebulized ipratropium bromide: a case series using quantitative pupilometer in Korea.
Acute Crit Care
November 2024
Department of Neurology, Seoul National University Hospital, Seoul, Korea.
Background: Abnormal pupillary reactivity is a neurological emergency requiring prompt evaluation to identify its underlying causes. Although isolated unilateral mydriasis without accompanying neurological abnormalities is rare, it has occasionally been associated with nebulizer use. We aimed to quantitatively assess pupillary changes using a pupillometer in cases of isolated mydriasis, which has not been described in previous studies.
View Article and Find Full Text PDFUnilateral mydriasis as a first presentation of pituitary macroadenoma.
BMJ Case Rep
July 2024
Endocrinology, AZ Sint-Jan Brugge, Brugge, Belgium
Correlation of preoperative inflammatory factors and emotional disorders with postoperative delirium in patients with craniocerebral trauma.
World J Psychiatry
July 2024
Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde 415003, Hunan Province, China.
Background: Traumatic brain injury (TBI) imposes a substantial societal and familial burden due to its high disability and fatality rates, rendering it a serious public health problem. Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium (POD), which affects their quality of life. Anxiety has been linked to increased POD incidence in some studies, while others have found no correlation.
View Article and Find Full Text PDFAnaplastic Transformation of Sphenoid Wing Meningioma With Orbital and Cavernous Sinus Invasion: Unveiling the Aggressive Nature.
Cureus
March 2024
Department of Neurological Surgery, Medical University of Plovdiv, Plovdiv, BGR.
Article Synopsis
- * A 70-year-old female presented with vision issues and underwent surgery after MRI revealed a tumor that was impacting key areas near her left optic nerve.
- * Although total tumor removal wasn't possible during surgery, the patient had a successful operation without complications and later received radiation therapy that eliminated the remaining tumor, with no signs of recurrence after six months.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!