creators_name: Vijayaraju, D creators_name: Ramkumar, S creators_name: Subramanian, SR creators_id: vijaydr@sify.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2015-02-21 14:36:13 lastmod: 2015-04-20 11:43:21 metadata_visibility: show title: Prallethrin Poisoning Presenting as Status Epilepticus ispublished: pub subjects: OJHAS full_text_status: public keywords: Pyrethroids; Status Epilepticus; Sodium Channel abstract: Mosquito repellents contain pyrethroid derivatives, as the active ingredient. Data regarding human toxicity following oral intake is limited. This is a case report of an individual who presented with neurotoxicity following oral ingestion of prallethrin (2.4% w/w) of a higher concentration present in formulations commercially available than previously. A 22 year old male presented to the emergency Room (ER) in status epilepticus. He was managed in the Intensive Care Unit (ICU). No cause for his status could be determined after all laboratory investigations. A review of history with the patient revealed that he had ingested a bottle of liquid mosquito repellent (45 ml). The patient has had no further symptoms on follow up and has been off anti epileptics. Pyrethroid containing mosquito repellents act on neuronal sodium channels causing hyperexcitiability. With no known specific antidotes, symptomatic treatment is the main stay of management. date: 2014-02-20 date_type: published publication: Online Journal of Health and Allied Sciences volume: 12 number: 4(11) publisher: Kakkilaya BS refereed: TRUE referencetext: 1. Milikan D, Rice B, Silbergleit R. Emergency Treatment of Status Epilepticus: Current Thinking. Emerg Med ClinN Am. 2009;27(1):101-113. 2. Holland MG. Insecticides: Organic Chlorines, Pyrethrins/Pyrethroids and DEET. In Hoffman RS, Nelson LS, Howland MA, Lewin NA, Flomembaun NE, Goldfrank LR (editors). Goldfrank’s Manual of Toxicologic Emergencies. New York: The McGraw-Hill Companies; 2007. P 851-54. 3. Bradberry SM, Cage SA, Proudfoot AT, Vale JA. Poisoning due to pyrethroids. Toxicol Rev.2005;24(2):93-106. 4. Philip CC, Deodhar D, John M. Prallethrin and Status- A Rare Association. The Internet Journal of Toxicology. 2010;7(2).DOI: 10.5580/8df Available at http://yester.ispub.com/journal/the-internet-journal-of-toxicology/volume-7-number-2/prallethrin-and-status-a-rare-association.html#sthash.OEALem1F.dpbs 5. Wolansky MJ, Harril JA. Neurobehavioral toxicology of pyrethroid insecticides in adult animals: A critical review. Neurotoxicology and Teratology. 2008;30:55–78. 6. Hossain MM, Suzuki T, Unno T, Komori S, Kobayashi H. Differential presynaptic actions of pyrethroid insecticides on glutamatergic and GABAergic neurons in the hippocampus. Toxicology. 2008;243:155–163. 7. Soderlund DM, Clark JM, Sheets LP et al. Mechanisms of pyrethroid neurotoxicity: implications for cumulative risk assessment. Toxicology. 2002;171:3–59. 8. Shafer TJ, Meyer DA. Effects of pyrethroids on voltage-sensitive calcium channels: a critical evaluation of strengths, weaknesses, data needs, and relationship to assessment of cumulative neurotoxicity. Toxicology and Applied Pharmacology. 2004;196:303–318. 9. Soderlund DM, Bloomquist JR. Neurotoxic actions of pyrethroid insecticides. Annu Rev Entomol. 1989;34:77-96. 10. Flannigan SA, Tucker SB, Key MM et al. Synthetic pyrethroid insecticides: A dermatological evaluation. Br J Ind Med.1985;42:363-72. citation: Vijayaraju, D and Ramkumar, S and Subramanian, SR (2014) Prallethrin Poisoning Presenting as Status Epilepticus. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/9718/1/2013-4-11.pdf