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Seizure following brief exposure to the insect repellent N,N-diethyl-m-toluamide
J W Lipscomb1, J E Kramer, J B Leikin
1Department of Pharmacy, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois.
Abstract:
A 5-year-old boy with a history of mild developmental delay experienced a major motor seizure at day camp after topical application that morning of the insect repellent Muskol and a later application of OFF [both contain N,N-Diethyl-m-toluamide (DEET)]. The patient continued convulsing in the emergency department and was treated with diazepam. Laboratory tests were unremarkable, as were lumbar puncture, computed tomography scan, and blood cultures. Skin decontamination was performed. DEET levels in the urine were 0.003 micrograms/mL. Although seizures and encephalopathic syndrome have been described with DEET in previous case reports involving topical exposure of pediatric patients, atypical aspects with regard to this case include that this patient was a male (most other case reports involve females), exposure was relatively brief compared with other reports, and the patient developed seizures without a prodrome described in previous reports. Avoidance of high-concentration DEET formulations in pediatric patients should be considered.
Insights
High-concentration DEET insect repellent exposure may cause seizures in children. This case highlights atypical seizure presentation in a young boy, emphasizing the need for caution with DEET products in pediatric patients.
Area of Science:
- Toxicology
- Pediatric Neurology
Background:
- N,N-Diethyl-m-toluamide (DEET) is a common insect repellent.
- Previous reports link DEET exposure to seizures and encephalopathic syndromes in children.
Observation:
- A 5-year-old boy experienced a major motor seizure after topical application of DEET-containing insect repellents.
- The patient had a brief exposure and presented with seizures without a prodrome, which is atypical.
- Standard laboratory tests, lumbar puncture, CT scan, and blood cultures were unremarkable.
Findings:
- DEET levels in the patient's urine were 0.003 micrograms/mL.
- The case presented atypical features compared to previous DEET-induced seizure reports, including patient's sex and lack of prodrome.
Implications:
- Avoidance of high-concentration DEET formulations in pediatric patients is recommended.
- This case underscores the potential neurotoxicity of DEET in children.
- Further research into DEET's neurological effects in pediatric populations may be warranted.