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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffered A Stroke. Given Haldol. Not Yet Opened His Eyes Yet, It Is Fixed. Advised Maybe Side Effects Of Medicine. Suggestions?

My father in law is currently in the hospital after suffering a stroke - He was administered Haldol during his hoisptalization when becoming agitated and has not opened his eyes since, his eyes are fixed and his left pupil is 6mm right 2 mm. This has been since last Friday June 22nd. His physician keeps telling us he will wake up within a couple of days and this is just a side effect of the medicine. (This is a Hospitalist giving this info) We have requested a Neurologist consult and he assures us this is not necessary. Can you give any hope or suggestions?
Sun, 30 Jun 2013
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Psychiatrist 's  Response
Hi,

Stroke is a condition related to reduced blood supply of the brain. It may be caused by many reasons like a bleed (in turn due to many reasons, hypertension being one the most common) or block in blood vessels etc. That part of the brain gets no blood during this time which leads to brain damage. The extent of brain damage manifests as what we see clinically as weakness of limbs and/or face. Dilated fixed pupils can also be seen as a part of the stroke.

Haloperidol (haldol) is an antipsychotic drug that is very commonly used to control agitation in bed ridden or comatose patients. Its side effects are mainly stiffness, slowness of movement or very little movement, tremor, occasionally-abrupt onset sometimes bizarre muscular spasms affecting mainly the musculature of the head and neck, increased salivation etc. This drug is not known to cause dilatation of one pupil.

You have not mentioned the GCS score of the patient nor the dose of the drug administered so i would not be able to comment further. It has varied effects in different individuals as far the extent of side effects are concerned. There are anticholinergic medications to reverse the side effects if severe. The safety of which will depend on the condition of the patient.

Discuss it with the treating doctor,
Wishing your father in law, best of health

Dr A Rao
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Suffered A Stroke. Given Haldol. Not Yet Opened His Eyes Yet, It Is Fixed. Advised Maybe Side Effects Of Medicine. Suggestions?

Hi, Stroke is a condition related to reduced blood supply of the brain. It may be caused by many reasons like a bleed (in turn due to many reasons, hypertension being one the most common) or block in blood vessels etc. That part of the brain gets no blood during this time which leads to brain damage. The extent of brain damage manifests as what we see clinically as weakness of limbs and/or face. Dilated fixed pupils can also be seen as a part of the stroke. Haloperidol (haldol) is an antipsychotic drug that is very commonly used to control agitation in bed ridden or comatose patients. Its side effects are mainly stiffness, slowness of movement or very little movement, tremor, occasionally-abrupt onset sometimes bizarre muscular spasms affecting mainly the musculature of the head and neck, increased salivation etc. This drug is not known to cause dilatation of one pupil. You have not mentioned the GCS score of the patient nor the dose of the drug administered so i would not be able to comment further. It has varied effects in different individuals as far the extent of side effects are concerned. There are anticholinergic medications to reverse the side effects if severe. The safety of which will depend on the condition of the patient. Discuss it with the treating doctor, Wishing your father in law, best of health Dr A Rao