This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Anaesthesia
An ICU patient on atracurium infusion develops seizures after 2 days. The most probable cause is – 
Select and explain. 
A. Accumulation of landonosine, B. Allergy to drug, C. Due to prolong infusion, D. All of the above
A: Accumulation of landonosine
Answer: A: Accumulation of landonosine 
Explanation: Hofmann degradation of atracurium produces tertiary metabolite laudanosine which can cross blood brain barrier and produces convulsions.