6세 남아에서 다량의 은행을 먹은 후 발생한 전신발작

Generalized Convulsions Caused by Overconsumption of Ginkgo Nuts in 6 Year-old Male

우리나라 아이들에게 흔하게 은행을 먹이고 있으나 대부분의 소아청소년과 의사나 아이를 가진 부모들이 은행 중독이 경련을 일으키고 응급처치가 이루어지지 않으면 사망할 수 있다는 것을 인식하지 못하고 있다. 이에 저자들은 다량의 은행 섭취 7시간후 발생한 전신 발작을 항경련제와 pyridoxalphosphate로 투여하여 경련 재발없이 치료한 1례를 경험 하였고, 소아청소년과 의사나 아이를 가진부모들에게 은행을 과량 먹으면 은행 중독에 의한신경학적 독성을 일으킬 수 있다는 경각심을 주고자본 증례를 보고하는 바이다

The ginkgo nuts are commonly eaten because of its nutritive value. It also taken as an herbal medicine for its antitussive and expectorant properties throughout Korea, Japan, and China. A range of symptoms of ginkgo nut intoxication including vomiting, abdominal pain, irritability, headaches, and seizures have been reported. It can be fetal in severe cases if emergency care was not available. It was discovered that the toxicity of ginkgo nuts was due to 4-O-methoxypyridoxine. The convulsion can be prevented by administration of anticonvulsants and pyridoxal phosphate. We report a 6-year-old male, without any past or family histories of epilepsy, who presented with generalized tonic clonic seizures. About 7 hours before the seizure, he had consumed approximately 40 roasted ginkgo nuts. He exhibited vomiting and abdominal pain 5 hours after ingestion. After treatment with diazepam and pyridoxal phosphate, his symptoms were resolved and electroencephalogram was normalized. We report on the patient and emphasize pediatricians and parents who have children should be recognizing that neurotoxicity of ginkgo nuts, particularity convulsion inducing effect, can occur occasionally.