CNS nontumor
Toxic and metabolic disorders

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

Revised: 30 July 2018, last major update February 2016

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Methanol [title] CNS
Page views in 2017: 110
Page views in 2018 to date: 175
Cite this page: Gyure, K.A. Methanol. website. Accessed December 18th, 2018.
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 description
  • Bilateral necrosis of putamen with or without hemorrhage
  • Contrast enhancement of the retrobulbar segment of the optic nerves
Radiology images

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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

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Contributed by Kymberly Gyure, M.D.

Microscopic (histologic) description
  • Degeneration of retinal ganglion cells
Differential diagnosis