The patient was transferred to our hospital for further management. Information from the patient's family revealed that he had had headache, nausea, vomiting, general weakness, visual disturbance, and shortness of breath 1 day before his admission. All the above symptoms occurred several hours after drinking an unknown amount of home-made herbal wine, which he obtained from a friend. He was successfully weaned from the respirator at our hospital. However, impaired consciousness, total blindness, and poor movement of his extremities were noted.
An electroencephalogram showed diffuse cerebral dysfunction, compatible with the diagnosis of metabolic encephalopathy. The initial fundoscopic examination in both eyes showed moderately swollen, hyperaemic optic disc and dilated, unresponsive pupillary reflex.
Visual-evoked potentials revealed marked suppression without identified waveform. Brain MRI performed on day 15 demonstrated multifocal necrosis in the bilateral putamen and frontal and occipital subcortical white matter regions, and marked perifocal vasogenic brain oedema Figure 1.
Over the following 3—4 days, his consciousness gradually recovered, he became alert, and his motor function steadily improved. However, total blindness in both eyes persisted. MRI on day 15 after methanol intoxication. High signal oedematous change was also noted in the optic disc of left eye arrowheads. At 2 months after the accident, his visual acuity was still no light perception in either eye. Fundoscopic examination showed bilateral optic atrophy and glaucomatous-like cupping of the optic disc with a narrow neuroretinal rim Figure 2.
Fluorescein angiography revealed hypoperfusion of the optic nerve head in both eyes, with an indiscernible neuroretinal rim. MRI on day 60 disclosed resolution of brain oedema. However, a residual putamen necrosis lesion was still noted. Fundus photography 2 months after methanol intoxication showed optic atrophy with glaucomatous-like cupping of the optic discs, and narrow neuroretinal rim with 0. There was generalized narrowing of the retinal arteries.
Methanol methyl alcohol is an uncommon but life-threatening poison. Despite knowledge of its toxicity, methanol is rarely substituted for ethyl alcohol by unscrupulous wine makers. Methanol is primarily metabolized in the liver by hepatic alcohol dehydrogenase to formaldehyde. Formaldehyde is then converted by aldehyde dehydrogenase to formic acid.
Although both formaldehyde and formic acid are extremely toxic, systemic metabolic acidosis caused by the accumulation of formic acid is thought to be the major toxic effect of methanol. Dyspnoea, coma, convulsion, and blindness may subsequently occur in severe poisoning.
As methanol poisoning is potentially fatal, its prompt diagnosis and treatment is very important. However, in the emergency room, acute methanol poisoning might not be readily diagnosed, especially when we are facing an unconscious patient as in this case.
Moreover, these toxicological facilities are not available in most hospitals. And, the laboratory results of methanol usually take more than 1 day to be complete. Wide serum anionic and osmotic gaps are auxiliary tools for its diagnosis, and fundoscopy might be another useful alternative.
The management of acute methanol poisoning is gastric lavage, correction of the metabolic acidosis, competitive inhibition of methanol oxidation by ethanol or 4-methypyrazole, and the removal of both formate and methanol by haemodialysis. Our patient survived. However, he had permanent visual sequelae, which might be due to severe metabolic acidosis and treatment delay. Once the ocular toxicities occur, the probability of vision recovery after poisoning is poor. Optic atrophy is a common outcome, 4 although according to a recent report high doses of intravenous steroids may protect the vision of patients with methanol-induced optic neuropathy.
In spite of this, benefit to the visual system was not obvious. Therefore, treatments should be given as early as possible, before the irreversible optic neurological damage occurs. Before we get move on, a reminder: Distilling alcohol is illegal without a federal fuel alcohol or distilled spirit plant permit as well as relevant state permits. Our distillation equipment is designed for legal uses only and the information in this article is for educational purposes only.
Please read our complete legal summary for more information on the legalities of distillation. Methyl alcohol methanol is the bad stuff that could be found in moonshine or any distilled spirit for that matter.
Pure methanol is very dangerous and it is definitely able to cause blindness and even kill people. As little as 10 ml of pure methanol could blind someone and as little as 30 ml could kill someone. Methanol is found naturally in certain fruits and vegetables. It may also be produced as an unintended byproduct during the fermentation process.
Spirits distilled from fruits, such as apples, oranges, and grapes, are more likely to contain methanol. Both beer and wine generally contain methanol. This makes distilled wine grappa, brandy, etc. If wine contains methanol but doesn't pose a risk of methanol poisoning then why is it potentially dangerous to drink once distilled? The difference is that the methanol concentration in, say, 5 gallons of wine, is evenly distributed among the 5 gallons.
For someone to ingest a potentially dangerous amount they would need to ingest more than 5 gallons During the distillation process methanol is concentrated at the start of the production run because it has a lower boiling point than ethanol and water. The boiling point of methanol is approximately degrees farenheit, which is quite a bit lower than ethanol the good stuff. This means that methanol F boiling temp will start to boil before the ethanol F boiling temp.
This is why commercial distillers always throw out the first bit of shine they produce from each production run more on this below. One way a commercial distiller would determine the presence of methanol is to monitor still temperature. If anything is produced by the still before wash temperature reaches degrees, it's methanol.
A commercial distiller will discard it. Glycol products from antifreeze have shown up in batches of moonshine as well. Republicans and Democrats have both made appearances in Glasgow for the giant climate conference. The quasar J is 13 billion light-years away from Earth. But it still can reveal a lot about our own universe. Brighstoneus simmondsi has a big lump around the nostrils, like a chunky alligator. Sign up to receive Popular Science's emails and get the highlights.
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