Three cases of wood-lover paralysis: clinical insights from Victoria, Australia.

INTRODUCTION

Wood-lover paralysis is a rare complication of Psilocybe mushroom ingestion. The clinical spectrum is poorly characterized and published cases remain limited.

CASE PRESENTATIONS: We describe three patients who developed acute muscle weakness following ingestion of Psilocybe mushrooms in Victoria, Australia. Written informed consent was obtained from these patients for publication of this case series.

• CASE 1: Mild generalized weakness affecting gait, without other end-organ involvement.

• CASE 2: Severe generalized weakness involving upper and lower limbs, associated with takotsubo cardiomyopathy.

• CASE 3: Severe generalized weakness with respiratory failure, requiring intubation.All patients had a clear temporal relationship between mushroom ingestion and symptom onset. Mushroom samples from Cases 2 and Case 3 were identified as Psilocybe subaeruginosa based on DNA sequence data. Serum toxicology detected psilocin in Case 1 and Case 3.

DISCUSSION: Our findings support a causal role for Psilocybe subaeruginosa; however, no specific alkaloid has yet been proven to cause wood-lover paralysis.

CONCLUSION

These cases highlight the variable severity of wood-lover paralysis, ranging from mild weakness to life-threatening respiratory compromise, and add significantly to the current body of literature on this topic.