Interesting case for medicos

A few days ago in emergency I saw a 12yo who presented with unequal pupils and headache. On closer history taking she had photophobia, headache and CHANGING unequal pupils. As in when I saw her, her left pupil was definately dilated compared to the right, but earlier her dad, her and her GP all said the right pupil was more dilated. This had been occurring for two days. No history of head injury, no history of a cold. Afebrile. Her pupils really were quite obvious, and it was kind of cool. Complete examination, including neurological, normal except diplopia on upward gaze.

As per my consultant we did a CT head and bloods. They were all normal. I put forth that perhaps it was a weird migraine. We contacted paeds registrar who said "migraine with neurological symptoms". I still at that point thought it was pretty interesting. She was admitted overnight just for observation.

However today I was covering paeds, and I asked one of the nurses how this particular patient was going. And the nurse told me the consultant had said the patient had hippus. Which is, according to the online dictionary "Spasmodic, rhythmical dilation and constriction of the pupil, independent of illumination, convergence, or psychic stimuli". How cool is that? I don't know too much more about it then that one sentence.