Bilateral tadpole pupils

摘要

A 19-year-old man with congenital erythropoietic protoporphyria and without family history or prior migraine attacks had recurrent seizures, which were controlled on propofol. Eye examination performed while awake revealed nonreacting bilateral tadpole pupils (TPs) (figure), without other neurologic deficits. He was hyponatremic (109 mmol/L), slowly corrected (134 mmol/L in 72 hours) but with episodic bilateral TPs persisting; orbitocranial MRI was normal.