Abstract Details

Title Chronic Methanol Toxicity Through Topical and Inhalational Routes Presenting as Vision Loss and Restricted Diffusion of the Optic Nerves on MRI: A Case Report and Literature Review

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 081

Objective Not applicable

Background Methanol intoxication can cause irreversible neurologic sequelae if unrecognized and untreated. While the most common form of toxicity is through ingestion, dermal and inhalational exposures should be highlighted as well. On review, dermal and inhalational routes of methanol toxicity particularly through chronic exposure have been documented rarely in literature. We report a case of a 57-year old female presenting in the emergency room with progressive dyspnea, metabolic acidosis with high anion gap, and metabolic encephalopathy. After emergency hemodialysis, the patient complained of vision loss on both eyes. Initial non-contrast cranial magnetic resonance imaging (MRI) revealed restricted diffusion of the intraorbital segment of both optic nerves. A thorough history revealed that she was applying a clear colorless liquid bought online all over her body for alleged pruritus for more than a year. The syndrome of metabolic acidosis with high anion gap, metabolic encephalopathy, vision loss, and laboratory findings led us to suspect a diagnosis of chronic methanol poisoning with an acute component. The liquid in question was sent for chemical analysis and result showed that it consisted of 95.5% Methanol.

Design/Methods Not applicable

Results Not applicable

Conclusions Methanol was isolated late in the course of this patient. As such, this case highlights the need for high index of clinical suspicion for methanol toxicity in the presence of vision loss and severe metabolic acidosis with high anion gap despite lacking history of toxic ingestion. The diffusion-weighted imaging (DWI) findings particularly in the optic nerves seen in the background of chronic exposure to methanol may be hypothesized as an unusual imaging feature and warrants further case documentation.

Authors/Disclosures
Christianne Mojica (SLMC) PRESENTER	Christianne Mojica has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Timothy Lim	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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