Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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August 27, 2012
Acute Methanol Intoxication
- Acute methanol intoxication produces severe metabolic acidosis because of conversion of formaldehyde to formic acid.
- Neurologic symptoms include headache, seizures, vision disturbances, and coma.
- Methanol is used as a constituent in a large number of industrial solvents, and, occasionally, it is used for fraudulent adulteration of wine or other spirits.
- Toxicity results from intentional overdose or accidental ingestion.
- Key Diagnostic Features: putaminal necrosis, subcortical white matter edema or necrosis, and optic nerve necrosis
- DDx: Wilson's disease, multiple system atrophy (Parkinsonism type or Shy-Drager type), hypoxic-ischemic encephalopathy, Creutzfeldt-Jakob disease, hyperammonemic encephalopathy
- Rx: supportive therapy, bicarbonate, fomepizole, hemodialysis
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