Acute Symptomatic Seizure Triggered by Eucalyptus Exposure in a Young Adult: A Case Report

Eucalyptus oil is a commonly used over-the-counter herbal preparation for the management of minor respiratory ailments and is widely perceived as safe. However, its principal constituent, 1,8-cineole, has been associated with neurotoxic and seizurogenic effects. We report the case of a 20-year-old male with no prior history of epilepsy who presented to the emergency department following an unwitnessed nocturnal seizure characterized by tongue bite, postictal confusion, and autonomic symptoms. The episode occurred after recent consumption of eucalyptus oil for upper respiratory tract infection. On evaluation, the patient was conscious and oriented with no focal neurological deficits. Laboratory investigations, including serum electrolytes and metabolic parameters, were within normal limits, while inflammatory markers were mildly elevated. Magnetic resonance imaging of the brain with epilepsy protocol and serial electroencephalograms revealed no epileptiform abnormalities. The temporal relationship between eucalyptus oil exposure and seizure onset, along with the absence of recurrent seizures following discontinuation of the oil, supported the diagnosis of an acute symptomatic seizure rather than epilepsy. Management included short-term antiepileptic therapy, withdrawal of the offending agent, and supportive care without the need for long-term antiepileptic medication. Clinical pharmacist involvement through detailed medication reconciliation, identification of eucalyptus oil as a probable trigger, and patient counselling played a key role in preventing recurrence. This case emphasizes the importance of clinician awareness and careful history taking regarding herbal and over-the-counter product use in patients presenting with first-episode seizures.