Cases of Star Anise Intoxication Seen in the Miami Children’s Hospital Emergency Department

PatientsSymptomsTea Amount and PreparationDuration of ExposurePhysical ExaminationLabs, EEGAdditional Neurologic Episodes on Follow-up?
Patient 1: 12-wk-old girlRight arm shaking followed by generalized tonic-clonic movementsFour stars boiled in 8 oz of water; given 3 oz every 4 h3 dNormal but had second tonic-clonic seizure in EDNormalNo at 2 y
Patient 2: 5-wk-old boyIrritability, jitteriness, and tonic posturingSix stars in 2–3 oz of water per day1 wkJitteriness and episode of tonic posturing in EDNormalNo at 2 y
Patient 3: 10-wk-old boyEmesis, myoclonic movements, recurrent tonic posturing, back archingFour stars boiled in 8–12 oz of water; given 1 ozOnceIntermittent myoclonic movements of all extremitiesNormalNo at 2 y
Patient 4: 6-wk-old girlEmesis, jitteriness, hyperexcitability, eye-rolling movementsUnknownOnceJitteriness and roving eye movementsNormalNo at 1 y
Patient 5: 3-wk-old boyEmesis, jitteriness, shaking, and upward gaze deviationTwo to 3 stars in 6 oz of water; given 1–2 oz several times weekly2 wkJitteriness, bilateral clonus, and increased deep tendon reflexesNormalNo at 1 y
Patient 6: 2-wk-old girlEmesis, upward gaze deviation, generalized myoclonic movements, pallorFive stars boiled in 8 oz of water; given 1 ozOnceMyoclonus and vertical nystagmusNormalNo at 6 mo
Patient 7: 3-wk-old girlIrritability, lethargy, jitteriness, myoclonic movements of the left legOne star boiled in 7 oz of water; given 1–2 oz 3–4 times per day6 dJitteriness with weak cryNormalNo at 3 mo
  • EEG indicates electroencephalogram; ED, emergency department.