Neurologic and ophthalmologic findings in children exposed to cocaine in utero.
We studied a cohort of 73 children exposed to cocaine in utero to characterize the spectrum of neurologic and ophthalmologic abnormalities; 36 children with no documented in utero drug exposure were selected as a control group. Most referrals of cocaine-exposed children to the child neurologist were made in the 1st year of life (81%). Reasons for referral were hypertonia (29%), seizures (22%), developmental delay (11%), tremulousness (11%), and hypotonia (4%). The most common abnormal finding in the cocaine-exposed children was hypertonia/hyperreflexia (63%), which was rarely seen in the control group. In addition, hypertonia/hyperreflexia was underdiagnosed by referring physicians. Similarly, hypotonia was seen on neurologic examination of cocaine-exposed children more frequently than documented by referral (16% versus 4%). Hypotonia was rarely seen in the control group. Twelve (43%) of 28 cocaine-exposed children seen by a pediatric ophthalmologist had structural ophthalmologic abnormalities. Neurologic and ophthalmologic findings suggesting structural lesions of the nervous system must be considered in cocaine-exposed children.
Tsay
C H
CH
Kaiser Permanente Medical Center, Oakland, CA, USA.
Partridge
J C
JC
Villarreal
S F
SF
Good
W V
WV
Ferriero
D M
DM
D002648:Child; D002675:Child, Preschool; D003042:Cocaine / Q000009:adverse effects*; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005315:Fetal Diseases / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D008297:Male; D008431:Maternal-Fetal Exchange; D008831:Microcephaly / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications*
D003042:Cocaine