CIRS Diagnosis: Physical Exam Findings

So what about some physical exam findings that might suggest SIRS that you wouldn't otherwise see? Well, there's, you know, one thing that I've used to see for years before that I didn't quite know as a marker for neuroinflammation is a fine tremor. Some people's tremor is so fine, you have to put a little piece of paper on their hand and you'll see the paper kind of shake. Sometimes you'll see abnormalities and reflexes. One of the things I've noticed is actually part of the SIRS of my dysautonomic patients is why I call it adrenal pupil. Well, you'll be shining a light in their eyeball, and it'll constrict down. So that's a parasympathetic vasoconstriction. But then there's sympathetic fight or flights. Like, this is dangerous. And it goes back open. You can actually see the pupil struggle. Is this a safe place or is it a dangerous place? And all of a sudden, you know, this person's neurological system is they have a mild, at least a mild form of dysautonomia.