Candy Overindulgence Leads to Seizures, Hypertension

Candy consumers may not want to over-indulge in licorice, as the candy has been associated with posterior reversible encephalopathy syndrome in a case study published in the journal Pediatric Neurology.

The report describes a 10-year-old boy who was admitted to a hospital in Bologna, Italy following a two-minute tonic-clonic seizure. Three generalized seizures occurred in the child over the next few hours; the patient also had elevated blood pressure (BP) and was complaining of a bad headache. Brain magnetic resonance imaging (MRI) revealed localized vasogenic edema, which coupled with the high BP, suggested posterior reversible encephalopathy syndrome (PRES). He was treated with a an angiotensin-converting enzyme inhibitor and amlodipine. 

In a follow-up examination one week later, doctors noted that the boy’s teeth were black and the patient admitted to eating at least 20 licorice candies per day for the past four months. This amount of licorice consumption resulted in a total daily intake of 2.88mg/kg of glycyrrhizic acid (an active ingredient of licorice), which exceeds the World Health Organization’s recommended maximum of 2mg/kg/day.  The doctors concluded that the excessive glycyrrhizic acid contributed to the development of hypertension and PRES. After stopping licorice consumption, antihypertensive treatment was gradually reduced and his blood pressure returned to normal; a considerable decrease of vasogenic edema was noted on brain MRI as well.

The authors warn that the risk of seizures from licorice is of particular concern in children with low body weight. Additionally, they urge that licorice candy manufacturers add a recommended daily amount on the product packaging to reduce the risk of future events.

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