Camphor is a pleasant smelling cyclic ketone of the hydro aromatic terpene group. The mechanism by which camphor produces toxicity is unknown. Within a period of 5 to 15 minutes, patients commonly complain of mucus membrane irritation, nausea, vomiting, and abdominal pain. Generalized tonic-clonic convulsions are often the first sign of significant toxicity and can occur soon after ingestion. Central nervous system depression is commonly seen, such as headache, dizziness, confusion, agitation, anxiety, hallucinations, myoclonus, and hyperreflexia.The aim of the study is to show a unique case of generalized tonic-clonic convulsions, after 1 week of dermal applications of camphor crème in elderly patient.
Case Report66-year old female was brought to the University Clinic for Toxicology in Skopje, with status epilepticus, after several generalized tonic-clonic seizures. At arrival, the patient was somnolent, with heavy headache, hypotensive (14/9 kPa), with partial amnesia, relax muscles, small amount of blood in mouth and specific odour. Five minutes later, during standard examination, the patient developed another generalized tonic-clonic seizure. An amount of 10 ml i.v. diazepam was applied to stabilize the patient, and a few minutes later the patient woke up. Heteroanamnesis taken from her husband showed that she had another similar convulsion ten days ago. EEG, CT and MRI made previously, did not show any abnormalities. The specific smelt, repeated seizures and especially the dermal application of Kamfart crème, made the suspicion of poisoning with camphor. The toxicological examination showed a positive result. After excluding the camphor crème, the patient didn't manifest any seizures.