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

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

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.

Mild generalized weakness affecting gait, without other end-organ involvement.

Severe generalized weakness involving upper and lower limbs, associated with takotsubo cardiomyopathy.

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.

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

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.