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Is there a need for ophthalmological examinations after a first seizure in paediatric patients?

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Abstract

In contrast to the recommendations of the International Liga against Epilepsy, many hospitals perform routinely complete ophthalmological examinations in children admitted after a first seizure. As there is no study available to date to prove the benefit of complete eye examinations in first seizure diagnosis, we conducted a study to analyse the value of a complete ophthalmological examination. All children aged 1 month to 18 years who were admitted to the children's university hospital of Leipzig with the clinical diagnosis of a first convulsive or non-convulsive afebrile seizure between 1999 and August 2005 were investigated. All children who had obtained a complete ophthalmological examination within 72 h after the seizure were included in the observational study. A total of 310 children were analysed in the study. Two hundred thirty patients had a tonic–clonic afebrile seizure, the others focal, complex-partial seizures or absences. Two hundred seven out of 310 children showed no ophthalmological pathologies. Eighty-three children had refraction anomalies or strabism, 18 children had optic atrophy, three had congenital eye muscle paresis, and three had malformations. A 16-year-old girl had a homonymous quadrantanopia due to an occipital glioglioma that caused the seizure. An 11-year-old girl had a retinal haemorrhage without any brain lesions after a fall caused by a first tonic–clonic seizure. None of the ophthalmological findings influenced directly the immediate clinical course of diagnosis and treatment of the seizure. Our data suggest that routine ophthalmological examination in all children does not have additional benefit in the first seizure diagnosis management.

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References

  1. Altman RL, Forman S, Brand DA (2007) Ophthalmologic findings in infants after an apparent life-threatening event. Eur J Ophthalmol 17:648–653

    CAS  PubMed  Google Scholar 

  2. Barcenilla ASC, de la Maza VT, Cuevas NC et al (2006) When a funduscopic examination is the clue of maltreatment diagnostic. Pediatr Emerg care 22:495–496

    Article  PubMed  Google Scholar 

  3. Diener HC, Putzki N (eds) (2008) Leitlinien für Diagnostik und Therapie in der Neurologie, 4th edn. New York, Thieme Verlag

    Google Scholar 

  4. Gilles FH, Sobel E, Leviton A et al (1992) Epidemiology of seizures in children with brain tumors. The Childhood Brain Tumor Consortium. J Neurooncol 12:53–68

    Article  CAS  PubMed  Google Scholar 

  5. Kuck H, Stark N (1988) Pediatric ophthalmology: reasons for examination and disease pictures. Klin Monatsbl Augenheilkd 192:712–716

    Article  CAS  PubMed  Google Scholar 

  6. Mei-Zahav M, Uziel Y, Raz J et al (2002) Convulsions and retinal haemorrhage: should we look further? Arch Dis Child 86:334–335

    Article  CAS  PubMed  Google Scholar 

  7. Miziara CS, Serrano VA, Kok F, Marques-Dias MJ (1988) The battered child syndrome: neurologic aspects in 7 cases. Arq Neuropsiquiatr 46:359–364

    CAS  PubMed  Google Scholar 

  8. Sandramouli S, Robinson R, Tsaloumas M, Willshaw HE (1997) Retinal haemorrhages and convulsions. Arch Dis Child 76:449–451

    Article  CAS  PubMed  Google Scholar 

  9. Sorensen PN (1977) Value of routine ophthalmologic examination in children with febrile convulsions. Ugeskr Laeger 139:2118–2119

    CAS  PubMed  Google Scholar 

  10. Steinlin MI, Blaser SI, Gilday DL et al (1995) Neurologic manifestations of pediatric systemic lupus erythematosus. Pediatr Neurol 13:191–197

    Article  CAS  PubMed  Google Scholar 

  11. Taer Fahnehjelm K, Wide K, Flodmark O et al (2003) Posterior ocular malformations in children: somatic, neuroradiological and cognitive aspects. Acta Paediatr 92:301–308

    Article  Google Scholar 

  12. Tyagi AK, Scotcher S, Kozeis N, Willshaw HE (1998) Can convulsions alone cause retinal haemorrhages in infants? Br J Ophthalmol 82:659–660

    Article  CAS  PubMed  Google Scholar 

  13. Yeung WL, Yam KL, Chan WM, Hui J (2003) Red eyes as the initial presentation of systemic meningococcal infection. J Paediatr Child Health 39:390–391

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Hospital for Children and Adolescents, University of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany

    Matthias K. Bernhard, Alexandra Gläser & Andreas Merkenschlager

  2. Department of Neurology, University of Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany

    Kathrin Ulrich

Authors
  1. Matthias K. Bernhard
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  2. Alexandra Gläser
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  3. Kathrin Ulrich
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  4. Andreas Merkenschlager
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Correspondence to Matthias K. Bernhard.

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Bernhard, M.K., Gläser, A., Ulrich, K. et al. Is there a need for ophthalmological examinations after a first seizure in paediatric patients?. Eur J Pediatr 169, 31–33 (2010). https://doi.org/10.1007/s00431-009-0966-4

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  • DOI: https://doi.org/10.1007/s00431-009-0966-4

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