Lamprocapnos spectabilis

Contact with the plant can cause skin irritation in certain individuals, due to its containing isoquinoline alkaloids, including protopine, while consumption of the leaves can give rise to neurological symptoms, including confusion and irritability. Jeong et al. reported a case of (non-fatal) poisoning in Korea in 2015: a party of four dining out at a local restaurant suffered symptoms of varying severity after consuming a dish of crucian carp and Korean radish greens to which a (possibly) careless or inexperienced chef had added leaves of L. spectabilis, which he may have mistaken for radish leaves, while gathering pot-herbs to cook with the fish. They note that the severity of poisoning could be correlated with the amount of the poisoned dish consumed; the only individual with symptoms requiring hospitalisation being a middle-aged man, already in poor health, who had eaten the most. All those poisoned complained of lethargy, dizziness, palpitation, and dry mouth half an hour after consuming the meal. The authors conclude that the clinical manifestations in this poisoning case suggest anticholinergic syndrome and speculate that the mental changes in the victims were attributable to the effects on the CNS of the alkaloids scoulerine (which can act as a GABAA receptor agonist) and corydine which can evoke narcotic effects. They note also that the neurologic effects of the alkaloid protopine are qualitatively comparable to those of the well-known delirient tropane alkaloid atropine. The 45-year-old male admitted to A&E suffering from Lamprocapnos poisoning had a history of hypertension and chronic kidney disease and presented with a confused mental state, elevated blood pressure, tachycardia, mild fever, dry mouth and facial flushing. Neurological examination revealed his confusion to be intermittent and associated with irritability, and an inability to comprehend and obey commands. His motor function, however was normal and he showed no abnormal reflexes. Furthermore, his pupils were not anisochoric (i.e. were of the same size) and (as would not be so in a case of atropine poisoning) were responsive to light. His mental state began to return to normal 19 hours after admission to A&E, although his intermittent confusion persisted. He finally regained alert (normal) mentation 28 hours after admission.