Abstract
Sikloplejikler çocukluk çağı göz hastalıklarının tanı ve tedavisinde yaygın kullanılan farmakolojik ajanlardır. Lokal uygulanırlıkları onların sistemik istenmeyen etkilerini gözardı etmemize neden olur. Siklopentolat ülkemizde en yaygın kullanılan sikloplejiktir. Bu yazıda 6 yaşında kız bir olgunun siklopentolat hidroklorürün %1‘lik solüsyondan gözlerine damlatılması sonucu gelişen nöropsikiyatrik sistemik istenmeyen etkileri ve izlemindeki gelişmeleri sunmak istedik. Göze damlatma işleminde sonraki yarım saat içerisinde olgumuzda sistemik istenmeyen etkiler gözlendi. Klinik olarak bilinç değişiklikleri, akut psikotik durum, konuşma ve denge bozuklukları, halüsinasyonlar, ataksi ve psikomotor ajitasyon gelişti. Olgunun izleminde herhangi bir antidot kullanımına gerek kalmadı. Saatler içerisinde klinik tablo düzeldi. Literatüre baktığımızda buna benzer bazı olguların tanımlanmış olduğunu gördük. Siklopentolatın yaygın kullanımı ve klinik tablonun gürültülü oluşu gözönünde bulundurulunca olgumuzda yaşadığımız tecrübeye ve literatürdeki deneyimlere dikkat çekmek istedik
Keywords
References
- 1. Bartlett JD. Administration of and adverse reactions to cycloplegic agents. Am J Optom Physiol Opt 1978;55:227-33.
- 2. Loewen N, Barry JC. The use of cycloplegic agents: Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology. Strabismus 2000;8:91-9.
- 3. Mutti DO, Zadnik K, Egashira S, Kish L, Twelker JD, Adams AJ. The effect of cycloplegia on measurement of the ocular components. Invest Ophthalmol Vis Sci 1994;35:515-27.
- 4. Laws DE, Morton C, Weindling M, Clark D. Systemic effects of screening for retinopathy of prematurity. Br J Ophthalmol 1996;80:425-8.
- 5. Derinoz O, Er A. Inability to walk, disequilibrium, incoherent speech, disorientation following the instillation of 1% cyclopentolate eyedrops: Case report. Pediatr Emerg Care 2012;28:59-60.
- 6. Demayo AP, Reidenberg MM. Grand mal seizure in a child 30 minutes after Cyclogyl (cyclopentolate hydrochloride) and 10% Neo-Synephrine (phenylephrine hydrochloride) eye drops were instilled. Pediatrics 2004;113:499-500.
- 7. Jiménez-Jiménez FJ, Alonso-Navarro H, Fernández-Díaz A, Adeva-Bartolomé MT, Ruiz-Ezquerro JJ, Martín-Prieto M. [Neurotoxic effects induced by the topical administration of cycloplegics. A case report and review of the literature]. Rev Neurol 2006;43:603-9.
- 8. Mirshahi A, Kohnen T. Acute psychotic reaction caused by topical cyclopentolate use for cycloplegic refraction before refractive surgery: Case report and review of the literature. J Cataract Refract Surg 2003;29:1026-30.
- 9. Tayman C, Mete E, Catal F, Akca H. Anaphylactic reaction due to cyclopentolate in a 4-year-old child. J Investig Allergol Clin Immunol 2010;20:347-8.
Abstract
Cycloplegics are using for diagnosis and treatment of eye disorders in childhood. They are treated locally. Because of this, side effects of the drug are generally ignored. Cyclopentolate is the most common cycloplegic drug in Turkey. İn this paper, we report a 6 year old girl who had neuropsychiatric side effects after instillation of cyclopentolate hydroclorur 1% . After half an hour of procedure, we observed side effects of the drug. These were blurred consciousness, acute psychiatric disorder, speech and behavioral disorders, ataxia and psychomotor agitation. There was no need for an antidote. The clinic picture was recovered within a few hours. In the literature, there were similar cases. Cyclopentolate is used commonly and side effects seem to be scary. Taking these into consideration, we point to our experiences and literature
Keywords
References
- 1. Bartlett JD. Administration of and adverse reactions to cycloplegic agents. Am J Optom Physiol Opt 1978;55:227-33.
- 2. Loewen N, Barry JC. The use of cycloplegic agents: Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology. Strabismus 2000;8:91-9.
- 3. Mutti DO, Zadnik K, Egashira S, Kish L, Twelker JD, Adams AJ. The effect of cycloplegia on measurement of the ocular components. Invest Ophthalmol Vis Sci 1994;35:515-27.
- 4. Laws DE, Morton C, Weindling M, Clark D. Systemic effects of screening for retinopathy of prematurity. Br J Ophthalmol 1996;80:425-8.
- 5. Derinoz O, Er A. Inability to walk, disequilibrium, incoherent speech, disorientation following the instillation of 1% cyclopentolate eyedrops: Case report. Pediatr Emerg Care 2012;28:59-60.
- 6. Demayo AP, Reidenberg MM. Grand mal seizure in a child 30 minutes after Cyclogyl (cyclopentolate hydrochloride) and 10% Neo-Synephrine (phenylephrine hydrochloride) eye drops were instilled. Pediatrics 2004;113:499-500.
- 7. Jiménez-Jiménez FJ, Alonso-Navarro H, Fernández-Díaz A, Adeva-Bartolomé MT, Ruiz-Ezquerro JJ, Martín-Prieto M. [Neurotoxic effects induced by the topical administration of cycloplegics. A case report and review of the literature]. Rev Neurol 2006;43:603-9.
- 8. Mirshahi A, Kohnen T. Acute psychotic reaction caused by topical cyclopentolate use for cycloplegic refraction before refractive surgery: Case report and review of the literature. J Cataract Refract Surg 2003;29:1026-30.
- 9. Tayman C, Mete E, Catal F, Akca H. Anaphylactic reaction due to cyclopentolate in a 4-year-old child. J Investig Allergol Clin Immunol 2010;20:347-8.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 1, 2015 |
| Published in Issue | Year 2015 Volume: 13 Issue: 3 |