The Relationship Between Retinal Haemorrhages and Status Epilepticus and a Literature Review of Retinal Haemorrhages in Young Children

Objective: To examine the relationship between retinal haemorrhages and status epilepticus in children under two years of age. Methods: This study involved a retrospective chart review of patients up to 24 months with status epilepticus admitted to a regional hospital in Hong Kong from 1994 to 2002. Occurrence of possible preceding events that were associated with retinal haemorrhages was recorded. These included cardiopulmonary resuscitation, head trauma, eye infection, vomiting and severe coughing bouts, evidence of raised intracranial pressure, leukaemia, arteriovenous malformation and bleeding tendencies. Retinal findings, underlying cause of status epilepticus and radiological features were also reviewed. Results: During the study period, there were 23 children aged two years or below (mean 11.7 months old; range, 30 days to 24 months) admitted with status epilepticus. They all had a complete neurological and fundoscopic examination. Twenty-two (96%) children did not have retinal haemorrhage. The only child (4%) with retinal haemorrhage had evidence of non-accidental injury. Conclusion: This study suggests that status epilepticus per se is unlikely to be associated with retinal haemorrhage in young children. If retinal haemorrhage is present, one should be alerted to the possibility of non-accidental injury.