Amanita muscaria contains more excitatory ibotenic acid and less depressant muscimol compared to Amanita pantherina. In this study A. muscaria poisoned patients were more often confused (26/32, p = 0.01) and agitated (20/32, p = 0.03) compared to those poisoned with A. pantherina (8/17 and 5/17). Patients poisoned with A. pantherina were more commonly comatose (5/17) compared to those poisoned with A. muscaria (2/32) (p = 0.03). In conclusion, the so-called ibotenic or pantherina-muscaria syndrome might be divided into two subtypes. •In neurological symptoms Amanita muscaria or pantherina poisoning should be considered.•A. muscaria results more often in confusion and agitation.•Amanita pantherina causes coma more often.•Pantherina-muscaria or ibotenic syndrome might be divided into two subtypes.