title: Abnormal pupillary activity in a brainstem-dead patient.
abstract: The pupils in brainstem-dead patients are classically fixed and dilated. We present a case of a brainstem-dead patient whose pupils displayed persistent asynchronous pupillary constriction and dilatation independent of external physical stimuli. Central causes for the phenomenon were excluded leaving an unexplained peripheral cause as the most likely explanation. Early recognition of this phenomenon prevents delay in the diagnosis of brainstem death, lessening to some extent the distress for the family, and facilitating earlier organ donation and allowing the better use of resources.
authors.affiliation: Neuro Intensive Care Unit, Radcliffe Infirmary, Oxford, UK.
authors.forename: D
authors.initials: D
authors.lastname: Shlugman
authors.forename: M
authors.initials: M
authors.lastname: Parulekar
authors.forename: J S
authors.initials: JS
authors.lastname: Elston
authors.forename: A
authors.initials: A
authors.lastname: Farmery
mesh_terms: D000328:Adult; D001926:Brain Death / Q000175:diagnosis / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000503:physiopathology; D006801:Humans; D012025:Reflex, Pupillary / Q000502:physiology*