Occasional Unequal Pupils.

I wanted to get your opinion on occasional unequal pupils. Is it normal for a person to have unequal pupils from time to time..Just slightly. Could this be in response to light differences or shadows etc. And during migraines. Not big differnces just slight..people have suggested this is seriuos but I feel its light related. i would apprecite an opinion on this and the possible causes of Hypereflexia (Knee Jerk only) 3+ and 4+. transient especially during stress and Migraine no other neuro abnormals other than the knee jerk. And the occasionl temp pupil difference(slight)?
Thank You

[CCF-Neuro-M.D.-RPS]

Dear BJP:

It is common to have unequal pupil size from time to time.  This would be especially true in migraine where this might be a result of the migraine (depends on where the events is occurring).  Actually, 3/4 reflexes are normal, 4+ is always abnormal as this is usually defined as clonus.  I would question who did the testing however, because clonus is a static lesion and should not be intermittent.  

Sincerely,

CCF Neuro MD

[BJP]

Thank You so very much for the information and help. Your service is very helpful and its good to know the pupil activity can be normal. As is the reflex issue.   Thanks