does my daughter have epilepsy or not? - #11483
She(18F) took eucalyptus oil 5ml and had 2 GTCS on one day(2/1/25), and she was prescribed phenytoin 100mg thrice daily and leviteracetam 500mg twice daily and EEG was taken on 5/1/25 which showed BACKGROUND : Awake record shows 8-9Hz alpha activity of 60 ot 100uV, which is wel modulated and most prominent over bilateral occipital regions, with normal reactivity to eyes opening. SLEEP : Normal physiological sleep related activity was seen. TRANSIENTS : There were frequent burst of sharp and slow wave discharges seen over both the hemispheres lasting for a period of 0.5-1 second. PROCEDURES: There was normal response to hyperventilation and photic stimulation. OTHER OBSERVATIONS: NIL. CLINICAL CORRELATION: INTER-ICTAL RECORD S/O GENERALIZED EPILEPSY Is the EEG due toeucalyptus oil or epilepsy? Please reply
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Doctors’ responses
1. Ingestion of eucalyptus oil (5 ml) is known to cause seizures, especially generalized tonic-clonic type, even in previously healthy people.
2. However, the EEG findings (sharp and slow wave discharges bilaterally, inter-ictal record suggestive of generalized epilepsy) indicate an underlying predisposition to epilepsy, not just a toxin effect.
3. The fact that discharges were seen independent of the seizure event suggests a possibility of generalized epilepsy.
4. Current medicines (phenytoin and levetiracetam) are appropriate to control seizures and should not be stopped without neurologist guidance.
Due to the complexity of the situation, it’s necessary to clearly differentiate between the effects of the eucalyptus oil ingestion and the underlying risk of an epileptic disorder. The EEG you mentioned shows “frequent burst of sharp and slow wave discharges” and includes an impression of “INTER-ICTAL RECORD S/O GENERALIZED EPILEPSY” which is indicative of epileptic activity. Eucalyptus oil ingestion is known to have toxic effects and, in excessive amounts, might provoke seizures. However, the presence of generalized epileptiform activity on the EEG suggests there might be an underlying predisposition to epilepsy, not just a reaction to the eucalyptus oil. Phenytoin and levetiracetam are both anti-seizure medications that will help manage seizure activity regardless of the cause, but it’s crucial to identify and address any underlying seizure disorder correctly for long-term management. It would be essential to work closely with a neurologist to distinguish whether these EEG findings are primarily due to the toxicity from eucalyptus oil ingestion or if an epileptic condition is present. It may require careful monitoring, repeat evaluations, and possibly even additional testing. Seizures from toxic exposure usually resolve with time and supportive care, whereas epilepsy will need ongoing treatment. Ongoing evaluation will help guide whether long-term medication management is necessary. Additionally, it’s essential to ensure that she avoids exposure to known seizure triggers while further diagnostic processes continue.
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