case_images: PMC5385912_01
case_images: Right pupil with oval shape unresponsive to light stimulation delayed dilatation after accommodation; contracted briskly to accommodation and pilocarpine 0.125%.
case_images: CRINM2017-4919758.001.jpg
case_images: PMC5385912_01_CRINM2017-4919758.001.jpg
case_images: fig1
case_images: Her right pupil was 1.5 mm and had an oval shape, with no response to light (Figure 1); the left pupil measured about 6 mm and responded very poorly to light.
case_images: HRV in the supine position. (a) The total Fourier spectrum, (b) the histogram, (c) the tachogram, and (d) the Poincare plot. The sympathovagal balance (SVB = LF/HF) was 1.31 versus 0.85 +- 0.3 in controls. The total power of LF was 6.4 versus 8.1 +- 2.5 in controls, and the total power of HF 4.9 versus 10.1 +- 3.6 in controls. The tachogram, the histogram, and the Poincare plot show a loss of variability across all frequencies.
case_images: CRINM2017-4919758.002.jpg
case_images: PMC5385912_01_CRINM2017-4919758.002.jpg
case_images: fig2
case_images: The HRV was ostensibly decreased in the time domain in the supine and standing position and also during rhythmic breathing (Figures 2, 3, and 4).
case_images: HRV in the standing position. (a) The total Fourier spectrum, (b) the histogram, (c) the tachogram, and (d) and the Poincare plot. In (a), the sympathovagal balance is included (SVB = 1.62 versus 1.5 +- 0.6 in controls). The normal SVB seems to be due to a severe reduction of the total power of HF and a less severe reduction of LF so the ratio remained normal. The total power of LF was 5.0 versus 6.2 +- 1.9 in controls, and the total power of HF was 3.10 versus 10.1 +- 3.6 in controls. There was a severe loss of variability across all frequencies.
case_images: CRINM2017-4919758.003.jpg
case_images: PMC5385912_01_CRINM2017-4919758.003.jpg
case_images: fig3
case_images: The HRV was ostensibly decreased in the time domain in the supine and standing position and also during rhythmic breathing (Figures 2, 3, and 4).
case_images: HRV during rhythmic breathing. (a) The total Fourier spectrum, (b) the histogram, (c) the tachogram, and (d) the Poincare plot. In (a), the sympathovagal balance is included (SVB = 3.27 versus 1.83 +- 0.5 in controls); the total power of LF was 2.8 versus 4.3 +- 2.4 in controls, and the total power of HF was 0.9 versus 2.4 +- 1.2 in controls. Although some respiratory driving is present, the magnitude of the driving is abnormally decreased.
case_images: CRINM2017-4919758.004.jpg
case_images: PMC5385912_01_CRINM2017-4919758.004.jpg
case_images: fig4
case_images: The HRV was ostensibly decreased in the time domain in the supine and standing position and also during rhythmic breathing (Figures 2, 3, and 4).