What is the probable diagnosis in a patient with a dilated pupil not responsive to 1% pilocarpine
Refer Goodman and Gilman 12e 1777 Looking at the option one by one diabetic third nerve palsy: third Nerve Palsy due to any reason will result in mydriasis( because oculomotor people milk supplies constrictor pupillae). As only one nerve is destroyed and but the receptors remain intact , so it will respond to 1% pilocarpine anthers miosis will occur adie's tunic pupil: it manifests as the denervation super sensitivity. Normal people respond to 1% pilocarpine but does not contract with highly diluted solution may also result in constriction Uncal herniation : IT results in pressure on 3rd cranial nerve and presents as dilated pupil but it will respond to pilocarpine as the receptors are intact
Diabetic third nerve palsy
Ade's pupil
Uncal Herniation
Pharmacological block
Autonomic nervous system