Sudden onset of anisocoria, no other symptoms

[mharper01]

Starting on Tuesday the 18th of Feb.  I had first experienced anisocoria.  My left pupil was dilated larger than my right pupil for several hours, but by the time I went to see a physician the symptoms had subsided.  The sudden onset was without any other type of symptoms.  I noticed the next day my symptoms have returned and was able to get to a doctor and they referred me to an opthlamologist.  

The opthlamologist ran through several tests and ruled out Horner's syndrome, said that it is likely that my anisocoria is attributed to migraines.  I was not experiencing any symptoms of migraines or even ophthalmic migraines, which I have had in the past.  I was ordered for an MRI as well as MRAs of my brain and neck.  All the tests came back normal and the opthlamologist is still persisting that it is due to migraines.

I have continued to have anisocoria go on and off almost on a daily basis; it will be there for hours at a time and then subside.  I have only had 2 days since the 18th that I have not had any episode of anisocoria.  My question is can this really be attributed to migraines when I have not had any type of symptoms?

[mharper01]

Thank you for your post.  I'm scheduled to see a neurologist on the 25th this month and have experienced a few of the symptoms of silent migraines, particularly food cravings, fatigue, and emotional/mental symptoms.  That could explain a lot.

Do you know what type of tests can e used to determine if silent migraines are occurring?

[Dr Santos]

Hi,
How are you? It is good that the initial diagnostic tests done were normal.This rules out possible aneurysm, bleeding, tumor, infection and eye issues. Migraine headache may be possible especially if the tests were unremarkable. Migraine may be asymptomatic and may not show any symptoms. Silent migraines do not cause pain but may present with diarrhea, nausea, vomiting, food cravings,loss of appetite, fatigue and even emotional and mental symptoms. If it persists, further evaluation may also be done. Seeking other neurologist's may also help ease any worry. Take care and do keep us posted.