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Benign episodic mydriasis is a form of anisocoria that is characterised by isolated, episodic, and sporadic mydriasis, in the absence of accompanying neurological or systemic signs or symptoms. The diagnosis is established after other causes of anisocoria have been excluded. The purpose of this case report is to describe a case of benign episodic mydriasis of her right pupil in a 23-year-old female patient. The episodes lasted for 5–10 minutes and occurred spontaneously, without any concomitant symptoms or precipitating factors. The frequency of the episodes was variable, but she reported that it worsened in periods when she felt more mentally stressed or anxious. Contact with any kind of medications, homoeopathic drugs, industrial agents, or any other kind of chemical compounds was excluded, and the remaining neurological and systemic examination was unremarkable. Blood tests were taken and imaging was performed, which ruled out a structural lesion. A diagnosis of isolated benign episodic mydriasis was established. Unlike the typical presentation of the condition, the episodes did not occur in association with any form of migraine or headache. Given the benign nature of the condition, no treatment was instituted. After excluding potentially severe causes, and reassuring the patient, the frequency of the episodes decreased. [ABSTRACT FROM AUTHOR]

This is a case report of a 29-year-old female patient who developed unilateral mydriasis following the use of a scopolamine patch for the prevention of postoperative nausea and vomiting (PONV). Given a medical history showing multiple risk factors for PONV, a preauricular scopolamine patch was applied prior to the induction of anesthesia. General anesthesia was induced with 150 mg propofol and 25 μg sufentanil and maintained with total intravenous anesthesia, using propofol (5 mg/kg per h) and remifentanil (2–3 μg/kg per h). Following an uneventful surgery of 90min duration, the patient was extubated and transferred to the recovery room, where the patch was removed. During the orthopedic ward round the following day, the clinical examination revealed anisocoria of the left eye in the form of unilateral mydriasis. In order to determine the cause of this clinical presentation, further neurological and ophthalmological examinations and investigations were carried out. In addition, magnetic resonance imaging was conducted to rule out a central nervous cause. The results of the investigations were negative and no pathology was identified. In addition, the symptoms resolved within 24 h of onset without any therapeutic intervention. Therefore, a suspected diagnosis of a pharmacologically induced anisocoria from the scopolamine patch was made, whereby the substance accidentally reached the affected left eye. Previous studies showed that scopolamine patches may reduce early emetic symptoms. Case reports describing the occurrence of anisocoria following the application of scopolamine patches have been previously published. In all of these cases the patches were used to prevent PONV and each case was comprehensively investigated using various diagnostic and clinical tools. It should be noted, however, that a dysfunctional accommodation is listed as a common side effect of the drug, affecting more than 1 in 10 patients. Even though the efficacy of scopolamine patches for the prevention of PONV is proven, clinicians should be aware of the common ophthalmological side effect. Particularly with respect to various surgical disciplines, where anisocoria may indicate an underlying surgery-related complication, the application of scopolamine patches should be well- considered. [ABSTRACT FROM AUTHOR]

Introduction. – Pourfour du Petit syndrome, rarely reported, is the opposite of Claude Bernard-Horner syndrome.Exegesis. – A 67 years old female is hospitalised for dysphagia, allowing the discovery of oesophagus carcinoma with mediastinal, pleural and costal extension. The discovery of left unilateral mydriasis associated with exophthalmos and eyelid retraction suggest Pourfour du Petit syndrome ; this diagnosis is confirmed by CT-scan, finding pedicular lysis of high dorsal vertebras and intra-canalar tumoral extension.Conclusion. – Pourfour du Petit syndrome has the same localisation value and the same aetiologies as Claude Bernard-Horner syndrome, but its mechanism proceeds byan exciting lesion of cervical sympathetic nervous system. The recognition of this entity can allow the diagnosis of pathologies that need emergency treatment. [Copyright &y& Elsevier]

Case We report the case of a patient who presented with unilateral mydriasis after a scopolamine patch application. The specific clinical context (cancer) reported here may have led to the misinterpretation of the etiology of mydriasis. Conclusion Our case description warns against diagnostic mistakes related to this side effect and highlights the advantages of pilocarpine test in the differential diagnosis of unilateral mydriasis. [ABSTRACT FROM AUTHOR]

We present the case of a patient who had a 3-year history of episodes of transitory unilateral mydriasis with omolateral blurred vision followed by headache. Thereafter, during the last 4 years, the patient developed a migraine with visual aura, without further episodes of transitory mydriasis. We suggest that the transitory mydriasis previously present could be considered as an unusual form of migrainous aura. A possible pathogenetic mechanism is proposed. [ABSTRACT FROM AUTHOR]