There have been reports of neem oil poisoning in children. It resulted in vomiting, hepatic toxicity, recurrent generalized seizures, leukocytosis, symptoms of Reye’s syndrome, metabolic acidosis, and encephalopathy. In another report, 10 children out of 12 died after single doses of neem oil with features of toxic encephalopathy and metabolic acidosis. Neem pesticide injection by an adult caused encephalopathy and metabolic acidosis. There is no specific antidote for neem oil poisoning. Azadirachtin irritates the eyes, stomach, skin.