Blown Pupil?

[ajax]

Has anyone ever blown a pupil from having seizures? I may have been concussed just falling from standing (I'm almost six feet), but i wonder if it could've been caused by the seizures independently. Also I'm more than 24 hrs out of the woods and I have a clean CT, so we're not worried about increased ICP really.

 

[Endless]

Concussion? Like you don't have enough to deal with already. I'm so sorry.
Concussions can affect your seizures. Are you feeling okay otherwise?

Anyway, did a bit of googling.

Emergency Medicine. Go wayyyyyy down the page to "What the Pupils Indicate."

The classic fixed and dilated "blown pupil" is a unilateral phenomenon that may occur when a rapidly expanding intracranial mass, including blood from a hemorrhage, is compressing cranial nerve III. It may also represent herniation of the uncus of the temporal lobe.

Somebody in here asked about pupil size once, but I can't remember who. If you are reading this:

Waxing and waning pupil size may indicate seizure activity, even without tonic-clonic movement.

Wikipedia:

Mydriasis is a dilation of the pupil due to disease, trauma or the use of drugs. Normally, the pupil dilates in the dark and constricts in the light to respectively improve vividity at night and to protect the retina from sunlight damage during the day. A mydriatic pupil will remain excessively large even in a bright environment and is sometimes colloquially referred to as a "blown pupil". The opposite, constriction of the pupil, is referred to as miosis.

Autonomic neuropathyThe parasympathetic nervous supply, which causes constriction of the pupil, or miosis, is supplied by cranial nerve III, the oculomotor nerve. Damage to this nerve typically manifests itself as mydriasis, because the sympathetic supply to the pupil, which causes mydriasis, remains unaffected, and therefore unopposed. Multiple central nervous system disorders e.g. epilepsy, stroke are known to lead to temporal mydriasis as well.

Are you on Lamictal? If so, it could cause mydriasis:
http://www.ehealthme.com/ds/lamotrigine/mydriasis

http://pubget.com/paper/18539570

Autonomic signs and symptoms are a common feature of epileptic seizures. Although sympathetic activation responses are predominant, we can also find sympathetic inhibition and even an activation of the parasympathetic division of the autonomic nervous system, especially in partial seizures. These autonomic symptoms during seizures are thought to be the result of neuronal discharges arising from or spreading to cortical areas of the central autonomic network. Mydriasis, most commonly bilateral, is one of the most frequent findings.

So it sounds like yes, the blown pupil could be due to a seizure.

Do you still have the blown pupil? If so and you think it might be a seizure, you might be in status (a seizure lasting longer than 30 minutes) and that would be very serious. You'd need to go back to the hospital.

Is your doctor SURE you don't have raised ICP? What is that based on? A lack of other symptoms? A clear CT wouldn't tell you that the ICP is normal for sure. A lumbar puncture is the only way to be 100% positive, though I definitely don't recommend one of those unless you absolutely have to have one.

I hope everything resolves soon.

 

[elizzza811]

I was the one who asked about pupil size. Here's my post...

http://www.coping-with-epilepsy.com/forums/f23/seizures-pinpoint-pupils-pupil-size-11791/#post120325

Mine are pinpoint 24/7, no matter what the level of light/darkness in a room. During my seizure, my pupil actually grew larger momentarily and appeared closer to the larger size it used to be when I was healthy. So I was the opposite, I guess?

 

[Endless]

Elizzza,

I'd do some searches on "Miosis" and see what you find. Are your pupils constantly small? That points to it not being a seizure. Some of the articles I found in a google search pointed to specific areas of the brain where leisons can cause miosis. Was your CT/MRI normal?

 

[elizzza811]

My pupils are always tiny. The neurologist claims they do respond to light, but I don't think they respond to darkness appropriately, and they never check that.

And when I tell her my pupils are much smaller than they used to be, she claims it 'might have been the meds' I was on causing them to appear larger. So I rushed back ome and checked pictures from years ago when I wasn't on any meds whatsoever, and my pupils were HUGE, even in a lighted room. And I'm not on any meds today, and they are still tiny.

My MRI and MRA were normal.

 

[ajax]

Endless, you rock. Thank you so much. I don't feel like I'm stuck in a seizure at all. I actually had a neurologist tell me a couple years ago that I may have damaged my third cranial nerve on account that I have a droopy eyelid that hadn't been that way before. Interesting. Your powers of research are impeccable!

It's finally sunshiney here (go figure). I hope it doesn't intend on staying this way. Oh well.

Thanks again for your awesome reply.

 

[Endless]

Droopy eyelid? I have one of those. Third cranial nerve? I was told mine might be pressure on my 5th and 6th facial nerves. Interesting......

I am so glad to hear it isn't a seizure, because one that lasted that long would mean your brain was in a boatload of trouble. How much, I didn't want to say - a seizure that long would probably mean a lot of permanent damage, to say the very least. Not good.