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ABSTRACT 843: SEIZURE AS A CAUSE OF UNILATERAL MYDRIASIS IN CRITICAL PATIENTS

Kutlu, N.O.1; Emeksiz, S.1; Alkan, G.1; Alacakir, N.1; Caksen, H.2

Pediatric Critical Care Medicine: May 2014 - Volume 15 - Issue 4_suppl - p 188
doi: 10.1097/01.pcc.0000449569.17833.a7
Abstracts of the 7th World Congress on Pediatric Critical Care

1Pediatric Intensive Care Unit, Necmettin Erbakan University Meram Medical Scholl, Konya, Turkey 2Department of Pediatric Neurology, Necmettin Erbakan University Meram Medical Scholl, Konya, Turkey

Background and aims: Most of the time, anisocoria is usually suggestive sign of life threatening events such as brain edema, brain necrosis, tumor compression, or central nervous system infections, when encountered in intensive care. But it is also possible to find this symptom associated with less serious conditions like Adie syndrome, migraine, epilepsy and medications. So as to avoid unnecessary investigations and treatments in these kinds of situations, these reversible and relatively benign causes must be considered in differential diagnosis. Seizures cause a various of pupillary abnormalities that include mydriasis, miosis and hippus. Anisocoria was found to be associated with ictal activity in the amygdala and hippocampus. However, anisocoria and seizure association might not be excluded even in the absence of seizure activity on EEG. Swartz et al. were able to show EEG activity originated from amygdala by using depth electrodes in an experimental study. Althought the role of focal epilepsies on physiopathology of unilateral mydriasis delineated explicitly in experimental basotemporal epilepsies (Blum), there are limited case reports published in English language-literature. We would like to report two cases with anisocoria followed by seizure and discuss the other possible etiologies in this issue.

Keywords:

Anisocoria; Seizure; Ipratropium bromide

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies