In an otherwise stable autistic boy 13 years of age, recent detioration in behavior manifested by agressiveness. Noted at times of severe agitation to make eye contact and head-butt. Pupils noted to be irregular by 1-2mm,always notice larger on right. Also have observed some ovalness in appearance at times. Otherwise pupils are equal most of the time. Could these be seizure related? What could be the causes of the pupilary changes. Current meds are risperdal,dilantin.Lithium and clonidine.Any insight would be appreciated.Also much hyperactivity.