[Ethylene glycol poisoning complicated by central nervous system abnormalities]

We report a case of ethylene glycol (EG) poisoning complicated by central nervous system abnormalities. A long-distance truck driver aged 36 year old ingested 200ml of EG in a suicidal attempt. He was referred to our hospital from another hospital because of vomiting and altered mental status. On arrival at our hospital, he had low level of consciousness (Glasgow Coma Scale: E3V4M5), miosis, and external ophthalmoplegia. Laboratory analysis revealed a severe metabolic acidosis with wide anion gap. Many crystals were detected in the urinary sediment. After admission, acute oliguric renal failure required continuous hemodialysis for 6 days. Despite the treatment, the level of consciousness did not improve. The CT scan of the brain obtained on the fourth day revealed low density areas in the bilateral basal ganglia, mid brain and pons. The renal biopsy showed tubular oxalate deposits. After 12 days, the volume of urination increased. At the same time the mental status gradually recovered. He was discharged on 36 days after admission without any sequelae.