المشاركة الأصلية كتبت بواسطة د.محمود صلاح
Opthalmological consultation please :
A 18 month old male presenting to me at Emergency Room with history of fall from the bed 24 hour ago followed by crying without loss of consciousness then developed a high fever only without any other symptoms
O/E found to have a pinpoint pupil while the child was sleeping , no other signs detected for neurological abnormality , I called surgeon he admit the child for observation then after 15 min the pupils became reactive to light and normal - when awake
My question is : -
1- what is the cause of pinpoint pupil in this child specially when he was sleep and sure not related to the head trauma ?
2 - is there any relation between sleep and pin point pupil ?
3- what is DDx of pin point pupil
وشكر ا جزيلا لك
Dear Sir,
Thank you for your question
First of all I need to clarify 1 point.
Is it a miotic pupil or pinpoint
Regarding the first year of life, the dilator pupillae muscle isn't well developed, so all children pupils around this age are more miotic most of the time which is normal
During sleep there's absence of sympathetic stimuli so pupils tend to be miotic, which is also normal
As for pinpoint pupil, th most imp. DDx
Pontine hemorrhage
Morphia or like drugs
Organophosphates
Hope I was helpful & I'm open for any questions
Sincerely
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