First a little information about the patient: the patient is currently intubated receiving both propofol and Ativan. Among other medications; Dilantin and morphine. This patient is also a recreational drug user at home of both cocaine and Xanax. My question is: in assessing their neurological status, I was checking the response to light and the patient's pupils contract AND relax rhythmically several times until the light is taken away. They do not fix at a particular mm. I figure it is a response to the drugs and I received in report that this is a known thing, but I am curious if anyone else has seen this.
Dec 10, '12
Yep, it's called hippus... I've seen it a few times in my carreer... here's a wikipedia article about it
Hippus - Wikipedia, the free encyclopedia
From what our doc's tell us, its usually a normal finding, they never seem to be concerned when I find this in one of my kiddos.
Dec 10, '12
It can also be drug induced.
Hippus is visible, rhythmic, but irregular pupillary oscillations that are deliberate in time. It comprises 2 mm or more excursions and has no localizing significance.
2. Incipient cataracts
3. Central nervous system diseases, including the presence of total third cranial nerve palsy, hemiplegia, meningitis (acute), cerebral syphilis, tabes, general paralysis, myasthenia gravis, tumors of corpora quadrigemina, epileptics, Cheyne-Strokes breathing, multiple sclerosis (disseminated sclerosis), and cerebral tumors
4. Neurasthenia (nervous exhaustion, Beard disease)
5. Drugs, including the following:
Dec 12, '12
Excellent! Thank you so much for this information. As I suspected, it is indeed drug induced.
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