title: Bilateral Dilated Nonreactive Pupils in a Neonate After Surgery.
abstract: Fixed and dilated pupils are disturbing when encountered during a physical examination in the pediatric intensive care unit, particularly when sedation or neuromuscular blockade confounds the neurologic examination. Rocuronium, a nondepolarizing neuromuscular drug, does not cross the blood-brain barrier and is not considered a causative agent for fixed mydriasis. We report a case of bilateral fixed and dilated pupils in a 1-week-old low-birth-weight neonate, which we contend was secondary to centrally mediated neuromuscular blockade.
authors.affiliation: From the Division of Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Christine
authors.initials: C
authors.lastname: Joyce
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Greenwald
authors.forename: Peggy
authors.initials: P
authors.lastname: Han
mesh_terms: D000732:Androstanols / Q000009:adverse effects; D004385:Duodenostomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015878:Mydriasis / Q000175:diagnosis* / Q000209:etiology; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium