An Adult Case of Generalized Convulsions Caused by the Ingestion of Ginkgo biloba Seeds with Alcohol

Fumika Azuma; Kazuya Nokura; Tetsuharu Kako; Daisuke Kobayashi; Teruki Yoshimura; Keiji Wada

doi:10.2169/internalmedicine.4196-19

CASE REPORTS

An Adult Case of Generalized Convulsions Caused by the Ingestion of Ginkgo biloba Seeds with Alcohol

Fumika Azuma, Kazuya Nokura, Tetsuharu Kako, Daisuke Kobayashi, Teruki Yoshimura, Keiji Wada

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Keywords: Ginkgo biloba seeds poisoning, generalized convulsion, 4′-O-methylpyridoxine, pyridoxal phosphate, treatment, Ginkgotoxin

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 12 Pages 1555-1558

DOI https://doi.org/10.2169/internalmedicine.4196-19

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Abstract

A 64-year-old woman developed symptoms of vomiting and tonic-clonic convulsions 9.5 h after eating 50 roasted Ginkgo biloba seeds with 100 g of alcohol. The intravenous administration of pyridoxal phosphate effectively improved the symptoms. Blood samples were collected and stored over 35 h. The assessment of 4′-O-methylpyridoxine and vitamin B6 vitamers indicated high levels of both, but the pyridoxal phosphate levels were low during the acute stage. These results suggest that 4′-O-methylpyridoxine inhibits the transformation of vitamin B6 analogues to the active form, pyridoxal phosphate. In our case, alcohol may have extended the period until ginkgo intoxication appeared.

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