REFLEX AND DISEASE and pupils

Stroke

Increased reflexes, positive Babinski sign, and possible unequal pupils.

Traumatic brain injury

Increased reflexes and possible abnormal pupil responses.

Spinal cord injury

Reflexes may be absent at first and later become increased.

Multiple sclerosis

Increased reflexes and clonus.

Amyotrophic lateral sclerosis

Shows both upper motor neuron and lower motor neuron findings.

Peripheral neuropathy

Decreased reflexes.

Guillain Barre syndrome

Absent reflexes.

Hypothyroidism

Slowed reflexes.

Hyperthyroidism

increased reflexes.

Opioid use

Small pupils and decreased reflexes.

Stimulant use

Dilated pupils and increased reflexes.

Miosis

Small pupils, commonly caused by opioids.

Mydriasis

Dilated pupils, commonly caused by stimulants.

Anisocoria

Unequal pupil sizes, may indicate a neurological problem such as stroke.

Fixed dilated pupil

Does not respond to light and may indicate brain herniation.