In an unusual case, mehendi triggers seizures in 9-year-old; know why and when it may happen

But, it came to light that the girl’s seizures were not triggered by the mere application of mehendi, rather its fragrance that acted as the stimulus leading to the stimulation of functional anatomic networks. “The patient was prescribed sodium valproate, and her parents were advised to avoid exposure to henna. The girl is stable with no new seizure,” he added.

What type of reactions can mehendi cause and why?

Mehendi is the practice of drawing designs on someone’s hands, feet, back, or even forearms, with “henna,” a reddish-brown natural dye.

Mehendi or henna alone is harmless when it is prepared from the ground leaves of the plant Lawsonia inermis, whose active ingredient is a naphthoquinone, mixed with water or oil, said Dr Ravi Shekhar Jha, director and head, pulmonology, Fortis Hospitals, Faridabad. “When applied, it does not penetrate deeper into the skin layer (dermis) but only stains the epidermis (superficial layer of skin) a reddish-brown colour. It doesn’t cause any allergic reactions,” said Dr Jha.

However, after applying mehendi, some people may experience wheezing, itching, redness, burning and swelling of the skin, said Dr Vijay Singhal, senior consultant, dermatology at Sri Balaji Action Medical Institute.

Mehendi fragnance could also cause seizures? (Source: Getty Images/Thinkstock)

Agreed Dr Akriti Gupta, cosmetic dermatologist, Jivisha Clinic New Delhi, and especially warned against the use of black henna. “It should not be used by expectant mothers since it includes paraphenylenediamine (PPD), an unsafe dye, which can have serious adverse effects such rashes, blisters, and allergic reactions. Consult a doctor right away if you believe you have a black henna tattoo and your skin is suddenly sore or irritated,” said Dr Gupta.

Adding, Dr Jha and said that the problem can be more so when henna is adulterated with additives. “In the case of black henna, this additive is para-phenylenediamine (PPD), which is known to cause a delayed Type 4 sensitivity reaction. These delayed reactions may occur from 1-3 weeks after the application, and can even be immediate. PPD penetrates deeper than henna and passes into the dermis where it has access to the blood. Occasionally, it may cause a more severe systemic reaction and in children with glucose-6-phosphate dehydrogenase (G6PD) may result in acute hemolysis (the destruction of red blood cells which leads to the release of hemoglobin from within the red blood cells into the blood plasma),” Dr Jha said.

How does the smell of mehendi cause reactions?

Fragrance can cause sudden breathlessness in those patients who have allergic history, noted Dr Jha. “Sometimes, mehendi is mixed with oil which produces strong pungent smell, leading to irritation of respiratory mucosa, watering of eyes, sneezing and respiratory distress,” said Dr Jha.

Usually, the things that trigger seizures are bright light, bright sound, strong smell — like mehendi, paints, liquor — drug by default, and lack of sleep, shared Dr Ashish Gosar, Neurologist at Bhatia Hospital Mumbai. “A seizure arises from the lobes of the brain. There is a smelling center in the brain as well, so a strong smell can trigger this area and can cause electric disturbance. The five senses reside in the brain, which can trigger epilepsy. Seizure occurs on trigger, commonly in patient who have epilepsy,” Dr Gosar told indianexpress.com.

What can be done?

Children or adults who are diagnosed with Reflex Epilepsy should avoid the triggers that have been identified in their case, stressed Dr Pratibha Singhi, Head, Department of Pediatric Neurology, Amrita Hospital, Faridabad “Also, they may need anti-seizure medication to control the seizures,” she said.

What should one be mindful about?

According to Gupta,

*Always read the packet before using any henna products or dyes so that you know the exact contents.
*Check the product carefully to make sure it’s natural henna. If you are not sure that the product is natural henna, please don’t use it.
*Always do a patch test, even if it’s a product you’ve used before.
*Although heat can make henna develop darker, don’t be tempted to keep the room hot to get more out of the colour. Overheating can make you feel dizzy, and may raise your blood pressure.

Does it affect everyone?

According to Dr Gosar, epilepsy patients should be careful of exposure to strong smells like mehendi. “It is very unlikely for others to get a seizure with the smell unless they are not aware of having it and should evaluate if there is a genetic trait of epilepsy in the family history,” said Dr Gosar.

So, should you apply mehendi?

Dr Singhi explained that such an incident does not necessarily mean people should be dissuaded from applying mehendi. “Only if a person has had a seizure earlier because of a particular smell (in this case mehendi) then they would be advised not to get exposed to the same smell. The chemical structure of mehendi by itself does not cause epilepsy. Mehendi has been used for ages in India, and abroad not only for decorative purposes, but also for medicinal purposes. The very fact that this case has been brought to media attention reflects the rarity of the problem,” Dr Singhi added.

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