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Seizures associated with 1% cyclopentolate eyedrops
D A Fitzgerald1, R M Hanson, C West
1Department of Medicine, Children's Hospital, Sydney, Australia.
Insights
A young boy with cerebral palsy experienced seizures, facial flushing, and rapid heart rate after receiving cyclopentolate eye drops. This highlights a rare but serious atropine-like side effect in brain-damaged children.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Cyclopentolate is a widely used mydriatic agent in pediatric ophthalmology.
- Cerebral palsy can affect neurological function and drug metabolism.
- Mydriatic agents can have systemic side effects, particularly in vulnerable populations.
Observation:
- A 4.5-year-old boy with cerebral palsy developed seizures, facial flushing, and tachycardia post-cyclopentolate eye drop instillation.
- The patient had no prior history of seizures or epilepsy.
- The dosage of cyclopentolate was within the standard range for pediatric use.
Findings:
- The adverse event presented as an uncommon atropine-like systemic side effect.
- The child's underlying brain damage from cerebral palsy may have predisposed him to this reaction.
- No epileptic focus was identified in the patient, suggesting a drug-induced phenomenon.
Implications:
- Clinicians should be aware of the potential for serious systemic side effects of cyclopentolate in children with neurological impairments.
- Careful patient selection and monitoring are crucial when administering mydriatics to brain-damaged children.
- This case underscores the importance of considering drug-induced reactions in the differential diagnosis of seizures in pediatric patients.
Abstract:
A 4.5 year old boy with cerebral palsy presented with seizures associated with facial flushing and tachycardia following the instillation of 1% cyclopentolate, a commonly used mydriatic in paediatric practice. He had no prior history of convulsions. This case demonstrates the uncommon, though serious, atropine-like side effect of cyclopentolate eyedrops (Cyclogyl, Alcon) in usual dosage in a brain damaged child without an epileptic focus.