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?
Though anisocoria can be associated with primary cranial headaches; in the absence of headaches or other symptoms associated with primary headaches, it is unlikely to be the underlying etiology. MRI/ MRA would rule out ischaemia, space occupying lesions and raised intracranial pressure as a cause. Other possibilities include physiological anisocoria, autonomic syndromes, neuro-muscular causes, eye inflammation, glaucoma, medication side effect etc. Assuming ophthalmic causes have been ruled out, I would suggest considering an evaluation by a neurologist to consider other possibilities and depending on the cause diagnosed/ suspected, it can be managed accordingly.
Hope this is helpful.
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