A 45-year-old woman presented with profound watery diarrhoea, abdominal cramp and vomiting, followed by dysthesiae and paraesthesiae, generalised myalgia, retro-orbital pain and generalised pruritus approximately several hours after eating the internal organs of Sphyraena barracuda. She denied a past history of medical disease, surgery, trauma, medication use, or allergy to drugs or food. Moreover, her elder sister (51 years old), brother-in-law (59 years old) and son (25 years old) also complained of similar but less severe symptoms after eating the internal organ of S barracuda 2 weeks ago. The neurological examination disclosed clear consciousness, intact cranial nerve function and well muscle strength. The neuropsychological examination of the patient did not show callosal syndrome, for example, hemialexia, unilateral agraphia, unilateral agnosia and …