General description

Methanol poisoning occurs from exposure to methanol, often through accidental ingestion or intentional intake. Once in the body, methanol is metabolized in the liver to formaldehyde and formic acid, with formic acid contributing to metabolic acidosis that correlates with the severity of symptoms. Formic acid also inhibits mitochondrial cytochrome oxidase, impacting cellular respiration. Due to the slow metabolism of methanol, symptoms may appear 18–24 hours after ingestion.

Early symptoms of methanol poisoning include reduced consciousness, impaired motor abilities, vomiting, abdominal pain, and a characteristic odor on the breath. Visual disturbances can appear as soon as 12 hours post-exposure, with prolonged effects potentially leading to blindness or kidney failure. Even small amounts of methanol can be highly toxic and may result in death.

Radiographic features

MRI shows bilateral hemorrhagic changes in the putamen, with inhomogeneous T2WI and FLAIR hypointensity surrounded by hyperintensity, indicating edematous changes. Contrast enhancement may also be observed in the putamen, as well as in the tegmentum of the pons and optic nerves.