Episodic unilateral mydriasis and migraine

Area of Science:

• Neurology
• Ophthalmology

Background:

• Migraine is a common neurological disorder.
• Episodic unilateral mydriasis is a rare symptom associated with migraine.

Purpose of the Study:

• To investigate the clinical characteristics and potential mechanisms of episodic unilateral mydriasis in migraine patients.

Main Methods:

• Case series analysis of seven patients presenting with migraine and unilateral mydriasis.
• Clinical examination, including pupillary response testing.
• Review of patient history for migraine and associated symptoms.

Main Results:

• Seven female patients (ages 5-53) experienced unilateral mydriasis during migraine headaches.
• Mydriasis episodes lasted 15 minutes to 24 hours and persisted for months to decades.
• Pharmacological blockade was deemed unlikely due to normal accommodation and pupillary responses.
• A parasympatholytic origin was identified as the most probable cause.

Conclusions:

• Episodic unilateral mydriasis in migraine patients is likely neurogenic, possibly parasympatholytic.
• This pupillary phenomenon is generally benign and self-limiting.