The first patient was a 26-year-old man with chronic otitis media who presented to a regional emergency department with a Glasgow Coma Scale score of 3, fixed pupils
of 7 mm and a temperature of 40.
Outcome of brain trauma patients who have a Glasgow Coma Scale score of 3 and bilateral fixed pupils
in the field.
Bateman described the boy's lack of brain stem function, his fixed pupils
, the absence of blood flow to the head and other conditions he called "incompatible with life.
Botulism begins with cranial nerve paralysis, including diplopia, dilated and fixed pupils
, dysarthria, dysphagia, and dry throat.
Dilated fixed pupils
due to administration of high doses of dopamine hydrochloride.