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January 1975

Transient Benign Unilateral Pupillary Dilation

Arch Neurol. 1975;32(1):68. doi:10.1001/archneur.1975.00490430090021

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To the Editor.—  Despite their awareness of the value of pilocarpine 0.5% in differentiating mydriasis produced by pharmacologic blockade from that secondary to parasympathetic paralysis, Edelson et al in the July issue of the ARCHIVES (31:12, 1974), failed to use this substance in their own cases. My own recent experience with a case of this type suggests that failure to perform the test may give rise to serious errors of interpretation.

Report of a Case.—  A 15-year-old female inpatient was first seen on Oct 23, 1973, while she was recovering from an episode of right unilateral mydriasis. She had been admitted to the hospital on the afternoon of Oct 10 when she experienced the sudden onset of right supraorbital pain in right pupillary dilation. A neurologic examination on the morning of the day of admission showed the pupils to be equal and normally reactive to light. Examination on Oct 23

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