Fixed and dilated pupils by pupillometer in lateralized periodic discharges: a case report in the neurocritical care unit

Background: Fixed and dilated pupils (FDPs) have become synonymous with devastating neurological damage brainstem injury commonly associated mass effect herniation. Infrequently, changes in pupillary light response been described seizures; however, the loss of documented Neurological Pupil index has not well established patients seizures.Case Report: We present a case report describing middle-aged female patient focal status epilepticus intermittent FDPs. An abnormal occurred right hemispheric lateralized periodic discharges resolution anti-seizure medication escalation. To our knowledge, this is first description objective documentation reversible FDP as possible clinical correlate discharges. Conclusion: The use handheld automated pupillometry conjunction electroencephalogram (EEG) provided therapeutic direction. Further research warranted to fully describe mechanistic underpinnings these observations.