Question of the Day – Wednesday February 6, 2019

Question – What sub group of patients are reportedly most susceptible to the epileptogenic neurotoxicity associated with gyromitrin-containing mushrooms?

Answer- The cited reference notes “Gyromitrin-containing mushroom poisoning is characterized by self-limited headache, weakness, nausea, vomiting, abdominal cramping, and diarrhea, within 4 – 6 hours of ingestion. This sub-acute onset of gastrointestinal toxicity may, rarely, be followed by epileptogenic neurotoxicity, with vertigo, delirium, seizures, stupor, and coma, especially in the elderly and in patients on isoniazid prophylaxis or treatment for tuberculosis.” (Diaz J H. Syndromic diagnosis and management of confirmed mushroom poisonings. 2005 Crit Care Med 33(2):427-436)