Status Epilepticus Possibly Caused by Hair Dye Exposure in a Diabetic Man
Yong-Sik Jung, MD, Seok-Beom Kwon, MD, Suk Yun Kang, MD, San Jung, MD and Sung-Hee Hwang, MD, PhD
Department of Neurology, Hallym University College of Medicine, Seoul, Korea
Status Epilepticus Possibly Caused by Hair Dye Exposure in a Diabetic Man
Yong-Sik Jung, MD Seok-Beom Kwon, MD, Suk Yun Kang, MD, San Jung, MD and Sung-Hee Hwang, MD, PhD
Department of Neurology, Hallym University College of Medicine, Seoul, Korea
ABSTRACT
Background: Permanent hair dyes are most commonly based on para-phenylenediamine (PPD) or derivatives of PPD. Although toxic effects of PPD ingestion develop severe complications such as rhabdomyolysis with renal insufficiency and cardiomyopathy, adverse effects of cutaneous PPD intoxication are various from contact dermatitis to severe anaphylaxis. On the contrary, there was no report of PPD induced severe neurologic complication such as status epilepticus. Case Report: A 59-year-old diabetic man was admitted to an intensive care unit because of status epilepticus shortly after an hair dye exposure. Laboratory studies showed a very high serum glucose level (>400 mg/dL) and an elevated serum osmolarity (324 mOsmol/kg). His brain MRI was normal, and the EEG showed diffuse slow waves. The hair dye contained PPD and aminonitrophenol. He was patch-tested for PPD, which was positive. Conclusions: To our best knowledge, this is the first report of fatal adverse event developed after the application of hair dye in a compromised person.