Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Pupillary response with migraine

Forum: Neurology Forum
Topic: Neurology - General

Re: Pupillary response with migraine

Re: Pupillary response with migraine

Posted by CCF Neuro MD on October 10, 1997 at 12:54:26:

In Reply to: Pupillary response with migraine posted by Kristine on September 30, 1997 at 02:12:05:

: Hi- I have one more question, then I will try to leave you guys alone for awhile. First, I want to thank all of the doctors who take their time and effort to answer my questions.
With my migraines, I do have an aura. Part of the aura is very distinct, that is that my pupils become absolutely huge. To the point that my iris is almost invisible, they continue to be enlarged until the migraine is treated and then they return to normal size even though I have had narcotics, which usually makes people's pupils very constricted or pin point. Also, one is usually slightly larger than the other, which is the left one where my migraines occur-but I have read that the unequal pupils are fairly common. Any suggestions on why these symptoms happen?
-Thanks so much-Kristine


Hello, Kristine,
Mydriasis (dilation of pupil) has been reported to be a part of clinical presentation of migraine in some patients. One case report documented a woman with classic migraine had mydriasis transiently initially, followed by persistant mydriasis with the subsequent attacks. The hypothesis has been that this is due to interruption of parasympathetic innervation rather than sympathetic overactivity. So the main reason for this to happen is thought to be the disturbances of autonomic function.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.
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