Severe methanol poisoning with neurological sequelae: implications for diagnosis and management

Intern Med J. 2018 Mar;48(3):335-339. doi: 10.1111/imj.13725.

Abstract

A 22-year-old woman presented with methanol toxicity manifesting as headache, reduced conscious state and visual change after consuming home-made grappa. She progressed to a coma with fixed mydriasis and severe acidaemia (pH 6.55). She was treated with empirical antidote administration (intravenous ethanol) and enhanced elimination through haemodialysis. She survived despite her delayed presentation but developed significant neurological sequelae, including visual impairment. We provide an overview of key elements of diagnosis and recent updates in treatment recommendations.

Keywords: metabolic disorder; methanol poisoning; neurotoxicity; renal replacement therapy; toxicology.

Publication types

  • Case Reports

MeSH terms

  • Antidotes / administration & dosage
  • Brain / diagnostic imaging*
  • Disease Management*
  • Female
  • Humans
  • Methanol / poisoning*
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / diagnostic imaging*
  • Nervous System Diseases / therapy
  • Renal Dialysis / methods
  • Severity of Illness Index*
  • Young Adult

Substances

  • Antidotes
  • Methanol