Abstract
A 2-year-old girl required medical attention for a sudden onset of repetitive tonic-clonic
convulsions after ingesting 20–30 ginkgo seeds. Concentrations of the major forms
of circulating vitamin B6, pyridoxal-5′-phosphate (PLP), pyridoxal (PL), and 4-pyridoxic acid, as well as the
known ginkgo seed toxin 4′-O-methylpyridoxine (MPN) were measured in the serum and cerebrospinal fluid (CSF).
PLP is an active form of vitamin B6 and necessary for γ-aminobutyric acid (GABA) production. High MPN concentrations
were observed in both the serum and CSF. As the PLP to PL ratio was markedly decreased
in serum and CSF examinations, we suspected the ratio to be important in GABA production.
This case report provides novel information on the metabolism of vitamin B6 in humans as a result of ginkgo seed poisoning.
Keywords
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Article info
Publication history
Published online: October 23, 2018
Accepted:
October 16,
2018
Received in revised form:
October 11,
2018
Received:
June 8,
2018
Identification
Copyright
© 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
