Acute methanol intoxication

Case contributed by Dr Ahmed Abdrabou

Presentation

Drowsiness, blurring of vision followed by coma. There was a suspicion of drug toxicity.

Patient Data

Age: 20 years
Gender: Male
CT

Bilateral symmetrical ill defined hypodensities involving the basal ganglia and subcortical white matter of both frontal lobes.

MRI

There was bilateral symmetrical signal alteration of the basal ganglia, mainly the putamen and caudate nuclei, and subcortical white matter of frontal regions displaying diffusion restriction, bright T2/FLAIR and low T1 signal. No hemorrhage was detected. 

Left temporal and right parietal subcortical recent lacunar infarctions were noted.

Case Discussion

After resuscitation of the patient from metabolic acidosis, he was found to have complete loss of vision of the right eye and poor vision of the left one. Opthalmological examination revealed optic nerve atrophy. 

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