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Neurologic and Ophthalmologic Findings in Children Exposed to Cocaine in Utero

Kaiser Permanente Medical Center, Oakland, CA

J. Colin Partridge, MD

Department of Pediatrics

Sylvia F. Villarreal, MD

Department of Pediatrics

William V. Good, MD

Department of Ophthalmology

Donna M. Ferriero, MD

Department of Neurology, San Francisco General Hospital, University of California, San Francisco

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. (J Child Neurol 1996;11:25-30).

Journal of Child Neurology, Vol. 11, No. 1, 25-30 (1996)
DOI: 10.1177/088307389601100106


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