PT  - JOURNAL ARTICLE
AU  - Alessia Giuseppina Servidio
AU  - Francesca Peri
AU  - Andrew Tenore
AU  - Laura Cesca
AU  - Laura Diplotti
AU  - Roberto Dall'Amico
AU  - Egidio Barbi
TI  - A well-appearing infant with a sudden anisocoria
AID  - 10.1136/archdischild-2020-319993
DP  - 2022 Apr 01
TA  - Archives of disease in childhood - Education & practice edition
PG  - 116--117
VI  - 107
IP  - 2
4099  - http://ep.bmj.com/content/107/2/116.short
4100  - http://ep.bmj.com/content/107/2/116.full
SO  - Arch Dis Child Educ Pract Ed2022 Apr 01; 107
AB  - Case presentation A 10-month-old boy was admitted to the emergency department due to a sudden onset of left unilateral mydriasis (figure 1). His medical history was unremarkable. A minor head trauma 2 days before was reported, without alarming signs or symptoms. His mother was putting him to sleep, after coming back from work, when she noticed a different pupil size and promptly went to the ED with her husband. The parents denied any use of medications, including nebulised therapy or direct contact with plants. The child was well appearing and his vital signs were within the standard age limits. His extraocular motility was normal as well as the rest of his neurological and physical examination. Parents’ behaviour was somehow remarkable. Even though the child was not suffering, the mother seemed very worried while the father was nervous and aggressive, repeatedly asking for a discharge.Figure 1 Left unilateral mydriasis.QuestionsWhat is the most likely diagnosis based on this clinical presentation?Local contact with a mydriatic substanceIntracerebral haemorrhageBrain tumourThird nerve palsyWhat would be the next step in the investigation to confirm this diagnosis?Brain CTBrain MRIFundus oculi examinationToxicological screening of urineHow is this condition managed, and what is the prognosis?Questions Answers can be found on page XX