CNS non tumor
Toxic and metabolic disorders

Author: Kymberly A. Gyure, M.D. (see Authors page)

Revised: 7 March 2016, last major update February 2016

Copyright: (c) 2005-2016,, Inc.

PubMed Search: Methanol [title] CNS
Cite this page: Methanol. website. Accessed April 27th, 2017.
Definition / General
  • Methanol is a clear, colorless alcohol that is commonly used in industrial products such as antifreeze and windshield wiper fluid; also perfumes, other solvents, commercial formaldehyde and illegally made alcohol
  • Toxicity occurs due to intentional overdose (as a substitute for ethanol) or accidental ingestion
  • Approximately 1,000 - 2,000 cases of methanol poisoning are reported in the United States each year
  • Poisoning affects putamen and optic nerves
Clinical Features
  • Headache, abdominal pain, nausea, vomiting, mental status changes
  • Loss of vision with hyperemia of the optic discs and a reduced papillary response to light
  • Elevated serum methanol levels
  • Metabolic acidosis: decreased total CO2 with increased anion gap
Radiology Images
  • Bilateral necrosis of putamen with or without hemorrhage
  • Contrast enhancement of the retrobulbar segment of the optic nerves
Radiology Images

Images hosted on Other servers:

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Hypodensity in bilateral putamen

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Bilateral symmetrical hypodensities

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Involves bilateral frontal lobes

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Lesions show
restriction of diffusion

Prognostic Factors
  • Permanent visual impairment occurs in some survivors of methanol poisoning
Case Reports
  • Delays methanol metabolism until methanol is eliminated from body either naturally or via dialysis.
  • Ethanol
  • Fomepizole: inhibitor of alcohol dehydrogenase
Gross Description
  • Hemorrhagic necrosis of putamina
Gross Images

Image hosted on PathOut server:

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Image courtesy of Kymberly Gyure, M.D.

Micro Description
  • Degeneration of retinal ganglion cells
Differential Diagnosis