Fixed Pupillary Light Reflex due to Peripheral Neuropathy after Liver Transplantation

• Main Authors: Kwan Hyung Kim, Namo Kim, Sungwon Na, Jaewon Jang, Jeongmin Kim
• Format: Article
• Language: English
• Published: Korean Society of Critical Care Medicine 2015-08-01
• Series: Korean Journal of Critical Care Medicine
• Subjects: Adie syndrome; liver transplantation; peripheral nervous system diseases; reflex, pupillary
• Online Access: http://kjccm.org/upload/pdf/kjccm-2015-30-3-191.pdf
• ISSN: 2383-4870; 2383-4889

A 46-year-old female patient was admitted to the intensive care unit (ICU) after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.