• A & A case reports · May 2016

    Case Reports

    Bilateral Dilated Nonreactive Pupils in a Neonate After Surgery.

    • Christine Joyce, Bruce M Greenwald, and Peggy Han.
    • From the Division of Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, New York.
    • A A Case Rep. 2016 May 1; 6 (9): 286-7.

    AbstractFixed and dilated pupils are disturbing when encountered during a physical examination in the pediatric intensive care unit, particularly when sedation or neuromuscular blockade confounds the neurologic examination. Rocuronium, a nondepolarizing neuromuscular drug, does not cross the blood-brain barrier and is not considered a causative agent for fixed mydriasis. We report a case of bilateral fixed and dilated pupils in a 1-week-old low-birth-weight neonate, which we contend was secondary to centrally mediated neuromuscular blockade.

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