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Convulsions and retinal haemorrhage: should we look further?
1Division of Paediatric Emergency Medicine, Department of Paediatrics, Sapir Medical Center, Kfar Saba, Sackler School of Medicine, Tel Aviv University, Israel. meir.mei-zahav@sickkids.ca
Insights
Retinal hemorrhages after convulsions are rare, occurring in only one child in this study. This finding necessitates a thorough investigation for underlying causes, including child abuse.
Area of Science:
- Pediatric Ophthalmology
- Neurology
- Child Abuse Forensics
Background:
- Retinal hemorrhages are often associated with child abuse.
- The occurrence of retinal hemorrhages following convulsions is not well-established.
Purpose of the Study:
- To determine the prevalence of retinal hemorrhages after convulsive episodes in children.
- To assess whether retinal hemorrhages warrant further investigation for abuse or systemic disorders.
Main Methods:
- A prospective study of 153 children (2 months to 2 years) presenting with convulsions.
- Ophthalmological examination was performed after initial history and physical assessment.
- Further investigations were conducted if retinal hemorrhages were detected.
Main Results:
- One child presented with unilateral retinal hemorrhages after a simple febrile convulsion.
- Extensive investigation ruled out other causes for the retinal hemorrhages in this case.
Conclusions:
- Retinal hemorrhages following convulsive episodes are infrequent.
- The presence of retinal hemorrhages necessitates a comprehensive workup to exclude child abuse and other underlying conditions.
Background And Aims:
The prevalence of retinal haemorrhages after convulsions is not well established. As these haemorrhages are considered characteristic of child abuse, we investigated their occurrence after convulsive episodes to see whether the finding of haemorrhage should prompt further investigation.
Methods:
Prospective study of 153 children (aged 2 months to 2 years), seen in the emergency department after a convulsive episode. After a thorough history and physical examination, a retinal examination was performed by an ophthalmologist. If findings were positive, further investigation was undertaken to rule out systemic disorder or child abuse.
Results:
One child was found with unilateral retinal haemorrhages following an episode of a simple febrile convulsion. A thorough investigation uncovered no other reason for this finding.
Conclusion:
Retinal haemorrhages following a convulsive episode are rare. Such a finding should trigger an extensive search for other reasons, including child abuse.