07/21/2025
PUPILS!
Aka the window into the autonomic nervous system.
Did you know your pupils are technically controlled by muscles?
The parasympathetic nervous system controls the pupil constrictors (makes the pupils smaller).
The sympathetic nervous system controls the pupil dilators (makes the pupils bigger).
What does it mean then if the pupils suddenly CONSTRICT during an eye movement, like gaze holding? And this patient has long COVID symptoms, including fatigue, brain fog and extreme loss of exercise tolerance?
That would be a failure of the SYMPATHETIC nervous system. They are also lacking sympathetic nervous system output to blood vessels so they aren’t likely getting adequate constriction of blood vessels to support the demand of the muscles during or the brain during cognitive tasks.
Would this be a good patient for ? Actually… no! But when we think , or , we often get stuck thinking we need to do vagus nerve stimulation. This is why exams are so important!
So, here’s the equation for this patient. Question: How do I stimulate her system to encourage adequate sympathetic output?
The answer: Left otolithic and eye exercises that bias activating the right midbrain.
