Q: What is the drug of choice in a patient who get admitted to ICU with poisonous mushroom ingestion, develop seizures which does not respond to standard anti-seizure medications?
Gyromitrin containing mushrooms are more prone to cause seizures. Usually benzodiazepines works well to control seizures. But if patient does not respond to standard anticonvulsants, pyridoxine is the next choice. Usual dose is 5 grams. Pyridoxine works via its involvement in synthesis of GABA within CNS and works well if administrated with benzodiazepines.
Michelot D, Toth B. Poisoning by Gyromitra esculenta--a review. J Appl Toxicol 1991; 11:235.