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Unusual cause of seizure
1Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Insights
Accidental ingestion of camphor-containing ointments by young children can lead to severe toxicity, including prolonged seizures. This case highlights the dangers of common household products and the need for increased awareness regarding pediatric poisoning risks.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Case Reports
Background:
- Camphor is a common ingredient in over-the-counter medicated ointments.
- Accidental ingestion of household products poses a risk to children.
- Pediatric poisoning cases require prompt recognition and management.
Observation:
- A 15-month-old child ingested 70 ml of a medicated ointment containing camphor, menthol, and eucalyptus oil.
- The estimated camphor dose was 280 mg/kg, exceeding the threshold for neurologic toxicity (> 50 mg/kg).
- The child experienced prolonged generalized tonic-clonic seizures approximately two hours after ingestion.
Findings:
- Acute camphor ingestion can cause delayed-onset, prolonged seizure activity in children.
- The toxicity is related to the dose ingested, with significant neurologic effects observed at > 50 mg/kg.
- Even low concentrations of camphor in ingested products can lead to dangerous levels.
Implications:
- Medicated ointments containing camphor represent a potential hazard for pediatric ingestion.
- Healthcare providers should maintain a high index of suspicion for camphor toxicity in children presenting with seizures.
- Public awareness campaigns regarding safe storage of household medications are crucial to prevent accidental pediatric poisonings.
Introduction:
This case report of camphor ingestion in a 15-month-old child illustrates the potential toxicity of a common household product. Details of the patient presentation are reported along with a review of the literature.
Methods:
Patient information was collected using the records of Poison Control, the Emergency Department, and the Health Records at the Hospital for Sick Children in Toronto, Ontario, Canada. A comprehensive review of the literature was conducted using the MEDLINE database for the time period 1966 to April 1995.
Discussion:
Oral ingestion of camphor is unusual, given that these products have both unpleasant taste and texture. This patient ingested 70 ml of an over-the-counter medicated ointment containing 4.73% camphor, 2.6% menthol, and 1.2% eucalyptus oil. While the concentration of camphor in this product is low, an estimated 280 mg/kg of camphor was consumed. With significant ingestion of camphor (> 50 mg/kg), neurologic toxicity is common. In this patient, prolonged generalized tonic-clonic seizure activity was noted approximately two hours post single acute ingestion of camphor. This delay in onset of seizure activity is atypical, as seizures have previously been noted to occur in the 90 minutes following ingestion.
Conclusion:
Readily available medicated ointments containing camphor have potential for serious or fatal consequences when ingested by children.