What is the probable diagnosis in a patient with a dilated pupil not responsive to 1% pilocarpine
Diabetic third nerve palsy
Ade's pupil
Uncal Herniation
Pharmacological block
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
Autonomic nervous system