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Case Reports of Children's Exposures
Of 17 cases of reported significant toxicity from DEET exposure during the period of 1961 to 2002, 14 were in children under the age of 8. The most frequently reported symptoms of DEET toxicity in children were lethargy, headaches, tremors, involuntary movements, seizures, and convulsions (Braissoulis et al. 2001; Osimitz and Grothaus 1995; Osimitz and Murphy 1997; Pronczuk de Garbino et al. 1983).
In children's exposures the route of intentional exposure is most often dermal, and accidental exposures most often are by ingestion of DEET solutions. In cases of significant DEET ingestion in children, impairment of gait, loss of muscle control, loss of consciousness, hypertonia, tremors and seizure (generalized) have been reported (Zadikoff 1979; Tenenbein 1987; Petrucci and Sardini 2000; Edwards and Johnson 1987). After an 18-month-old girl ingested an unknown quantity of Mylol® (10% DEET), she was admitted to the hospital. She was irritable and in an opisthotonic posture, suffering from periods of shaking and crying. Her muscle stretch reflexes were depressed, and her head control was poor. She was in the hospital for 6 weeks, in which her condition improved slowly. She was discharged to a local hospital for further recovery (Zadikoff 1979). The girl's symptoms are fairly typical of ingestion exposure in children; however the duration of her recovery process is much more prolonged than in any other case study reviewed.
An 18.5-month-old female who was sprayed with Deep Woods Off!® (20% DEET) daily for 3 months developed weakness, ataxia, uncontrollable tremors and increased drooling. DEET was found in the child's urine, and her white blood cell count was elevated. She improved after treatment with corticotrophin 3 times a day, and her condition improved to full recovery within 3 months (Edwards and Johnson 1987).
A 6-year old girl was admitted to the hospital with periumbilical tenderness, ataxia, and brisk reflexes of the ankle and knee. She had been exposed to a spray containing 15% DEET over extensive areas of the skin on more than 10 occasions. On the fourth day of her hospitalization, she became agitated, combative, and increasingly disoriented, with increased serum ammonia levels. Her condition deteriorated and she died 8 days after admission. Autopsy revealed that the child was a carrier for congenital OCT deficiency, which could have predisposed her to toxicity as a result of extensive exposure to DEET (Heick et al.1980; Pronczuk de Garbino et al. 1983; Osimitz and Murphy 1997).
Between June and August 1989, five cases (four boys aged 3-7 years and a 29-year-old man) of generalized seizures temporally associated with the dermal application of DEET occurred in the states of New York and Connecticut (CDC 1989). The patients had been exposed to varying concentrations of topically applied DEET, with generally fewer than three applications. The onset of seizures ranged from 8 to 48 hours after the last application. All patients quickly recovered. None of these cases clearly established that DEET was the toxic agent responsible for the seizures (CDC 1989).
A recent review regarding the safety of DEET-based insect repellents for children and pregnant and lactating women was presented by Koren et al. (2003).These authors concluded that the available evidence does not confirm that children are especially susceptible to the toxic effects of DEET and the etiology of adverse neurological outcomes associated with the DEET in children and adults has still not been determined. These conclusions are also supported by a review by Sudakin and Trevathan (2003) on the safety of DEET in the general population
--- In epilepsy@yahoogroup
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> I was wondering what bug spray is safe if i should use deet on my child with epilepsy i asked the nero they had no idea and the pediatrition said it was ok cause we dont want her to get west nile thanks
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> Keena
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