Unusual Pupil Dilation with 16 yo girl

[Dana821]

My daughter has suffered from fainting and seizures within the last year, now her pupils will dialate unevenly or become unresponsive when moving from a well lit room to a dimly lit room.  Her pupils will be very large in bright lights and one will be different from the other.  She comes up clear on a recent CTA of the brain.  We are pending a MRI 6/4, but I thought I'd ask.

She also complains that when she moves her eyes up, down, side to side it causes pain.  She has headaches and nausea as well.  So far the doctors have labled the seizures as unknown, her EEG was normal, no signs of stroke or seizures.

This is puzzling me a great deal and I'm worried about her.  Any suggestions would be appreciated. Thanks, worried mom

[Dana821]

Thanks Dr. Kutryb,  I will follow up on your advice.  We are just starting this journey to find out what could be causing this problem for her.  She also complains of a very sore neck, and as far as the fainting she has been to a Cardiologist but came out with a clean bill of health.  

I don't know if this has anything to do with it, but it seemed to all start after a bad case of sun poisoning about a year ago.  She's had Shingles since them on her lower back and sides.  For a child who never got sick prior she has had a multiple of strange problems since.  Another thing that came up about 2 years ago, she was biting her tongue in the middle of the night, her Orthodontist made an appliance for her to wear and about a year later it was over.

I know I'm grabbing at straws but these are some things that have occured and until the seizures started we just didn't think they could be connected?  Maybe they're not?  I'll f/u on your recommendations and see what direction they take us.  Thanks Dana

[Michael J Kutryb, MD]

My best advice is to have her see a neuro-ophthalmogist.  You can find one at www.aao.org and use find a physician feature.  This case has multiple levels of complexity so she should see a specialist. In the meantime her regular neurologist will be looking into whether she actually has real seizures or pseudo-seizures and of course what is going on with the fainting.  The eyes are just a small part of a more complex overall sitaution.

Michael Kutryb,MD
Kutryb Eye Institute
407 S. Washinton Ave.
Titusville, FL 32796
321-367-2020
www.kutrybeye.com