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PEDIATRICS Vol. 113 No. 5 May 2004, pp. e499-e500

ELECTRONIC ARTICLE

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

Alan P. Demayo, MD* and Marcus M. Reidenberg, MD{ddagger}

* Departments of Pediatrics
{ddagger} Pharmacology, Medicine, and Public Health, Weill Medical College of Cornell University, New York, New York

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.

Key Words: seizures • cyclopentolate • eye drops

Received for publication Oct 23, 2003; Accepted Dec 29, 2003.