Seizures associated with 1% cyclopentolate eyedrops

Fitzgerald, Dominic A.; Hanson, Ralph; West, Charles; Martin, Frank; Brown, J.; Kilham, Henry

doi:10.1111/j.1440-1754.1990.tb02399.x

Cited by 25 publications

(18 citation statements)

References 3 publications

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“…6,7 For this reason, 0.5% and 1% cyclopentolate usage is suggested. 1,7 However, systemic adverse effects may be seen after 1% cyclopentolate usage such as in our case. It was reported that healthy 23-month-old and 4.5-year-old boys suffer a seizure after 1% cyclopentolate instillation.…”

Section: Discussionmentioning

confidence: 84%

“…Adverse affects are rare and dose-dependent. 1,2 We report the occurrence of a significant systemic reaction to 1% cyclopentolate eyedrops in a normal dosage manifesting as inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation).…”

mentioning

confidence: 98%

“…It was reported that healthy 23-month-old and 4.5-year-old boys suffer a seizure after 1% cyclopentolate instillation. 1,8 The cause of central nervous system immaturity seizures may be seen more frequently in children than in adults. 2 Therefore, cyclopentolate should be managed carefully in patients with prior seizure history.…”

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confidence: 99%

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Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Derinöz

Er²

2012

Pediatric Emergency Care

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A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, although serious, atropine-like adverse effect of cyclopentolate eyedrops in usual dosage in child.

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Section: Discussionmentioning

confidence: 84%

mentioning

confidence: 98%

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Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Derinöz

Er²

2012

Pediatric Emergency Care

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“…Another three-month-old premature boy with mild developmental delay, antidiuretic hormone, and growth hormone deficiency experienced seizures after 0.5% cyclopentolate eye drops [1]. The other three children who experienced seizures were all neurologically impaired, implicating CNS immaturity or possible CNS abnormality as a factor predisposing to the clinical toxicity induced by this drug [8,9]. Also, higher concentrations appeared to result in increasing susceptibility to adverse effects of cyclopentolate in infants, young children, and children with spastic paralysis or other forms of CNS injury.…”

Section: Discussionmentioning

confidence: 99%

Focal seizures after instillation of cyclomydril to a neonate with congenital CMV infection

Dow

2014

Journal of Neonatal-Perinatal Medicine

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We present the case of a term neonate who underwent a diagnostic eye examination on day one for possible genetic disorders. Five minutes after Cyclomydril (0.2% clyclopentolate and 1% phenylephrine) eye drops were instilled, a focal seizure lasting for approximately one hour occurred. The electroencephalograph (EEG) was normal but the magnetic resonance imaging (MRI) revealed calcifications in the bilateral periventricular regions. Urine CMV-DNA and maternal serum CMV-IgM were both positive. Auditory brainstem testing suggested severe sensoneural hearing loss. The baby was treated for congenital CMV infection and did not have further seizures. In this case the congenital CMV infection may have been the predisposing factor to central nervous system (CNS) toxicity induced by cyclopentolate. The exact mechanism is unknown but severe neurological impairment may be considered a contraindication for cyclopentolate eye drops in the neonate. To our knowledge, this is the first report of seizures occurring within the first week of life secondary to cyclomydril eye drops in a term neonate.

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“…[1][2][3][4] This is because both the conjunctival and nasal mucus membranes are good drug-absorbing surfaces, 5,6 and eye drops pass readily through the nasolacrimal duct into the nose. Cases have been reported of seizures 7,8 and other forms of anticholinergic toxicity 9,10 after application of cyclopentolate eye drops.…”

Section: Discussionmentioning

confidence: 99%

Grand Mal Seizure in a Child 30 Minutes After Cyclogyl (Cyclopentolate Hydrochloride) and 10% Neo-Synephrine (Phenylephrine Hydrochloride) Eye Drops Were Instilled

Demayo¹,

Reidenberg

2004

Pediatrics

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ABSTRACT. A grand mal seizure is an unexpected, rare adverse event in a child receiving eye drops to dilate the pupils for an eye examination. A case is reported of a convulsion in a 23-month-old boy after he received Cyclogyl (cyclopentolate) and Neo-Synephrine (phenylephrine) eye drops before ophthalmoscopy. His serum sodium was 125 mEq/L, and he had low plasma pseudocholinesterase activity. Children exposed to organophosphate insecticides and other pseudocholinesterase inhibitors may be at risk for cyclopentolate toxicity. Pediatrics 2004;113:e499 -e500. URL: http://www.pediatrics.org/cgi/ content/full/113/5/e499; seizures, cyclopentolate, eye drops. P atients undergoing ophthalmoscopy in hospital for various reasons are given eye drops often for cycloplegia and mydriasis to facilitate examination of the retina. The agents commonly used are 10% phenylephrine eye drops to dilate the pupils and Cyclogyl (cyclopentolate) in the form of 0.5% or 1% eye drops to paralyze the iris (cycloplegia) temporarily. Cyclogyl is a muscarinic receptor antagonist similar to atropine. It shares certain rarely occurring side effects with atropine, which include the possibility of epileptic seizures. We present the case of a toddler without a prior history of seizures that had a grand mal seizure lasting 30 minutes after he got 1 drop in each eye, every 5 minutes, of 10% Neo-Synephrine and 1% Cyclogyl, for a total of 3 drops of each over a 15-minute period. His seizures began 45 minutes after he received the last dose of each eye drop. CASE REPORTA previously healthy 23-month-old white male infant came by ambulance to the hospital because of second and third degree scald burns involving both feet and ankles in stocking distribution. This injury was incurred by his being immersed at 6 pm in a tub of hot water. He was brought to a local emergency department by his mother 4 2 ⁄3 hours after the accident (she said she had been told by phone to wait and see whether his feet became blistered and swollen before coming in). He was triaged, stabilized, and burn-dressed in the local emergency department and transferred by ambulance to this hospital for treatment in our burn center.He arrived at our emergency department ϳ7 3 ⁄4 hours after the scalding. His temperature was 37.6°C, his pulse was 160 beats per minute, and his respirations were 32 per minute. He was crying, withdrawn, and in pain. He didn't talk. His weight was 11.88 kg (25th percentile), height was 93 cm (a little less than the 95th percentile), and head circumference was 49 cm (50th percentile). He showed a normal physical examination, except for a diaper rash, and a normal neurologic examination. There was no external evidence of head trauma or other trauma apart from the scald burns involving both feet and ankles in a stocking distribution. Some were of partial thickness, but most were full thickness.The local emergency department had referred his case to the City of New York Child Protective Services before he was transferred.In our emergency department he was given 1 mg o...

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Seizures associated with 1% cyclopentolate eyedrops

Cited by 25 publications

References 3 publications

Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Inability to Walk, Disequilibrium, Incoherent Speech, Disorientation Following the Instillation of 1% Cyclopentolate Eyedrops

Focal seizures after instillation of cyclomydril to a neonate with congenital CMV infection

Grand Mal Seizure in a Child 30 Minutes After Cyclogyl (Cyclopentolate Hydrochloride) and 10% Neo-Synephrine (Phenylephrine Hydrochloride) Eye Drops Were Instilled

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