[Parkinsonism after methyl alcohol poisoning]

Two cases of parkinsonism due to methyl alcohol poisoning are reported. In the first patient, parkinsonism features were mild and stable, while in the second they progressively developed in the weeks following the poisoning. None of the two patients had significant visual abnormalities during the clinical evolution. Both patients had symmetrical putaminal lesions in CT, and one in NMR imaging. The response to antiparkinsonism drugs was absent in one case and it could not be evaluated in the other because of patient's death. On the basis of theses two cases the clinical and therapeutic features of this type of striatal parkinsonism are compared with those with parkinsonism due to other toxic agents. In view of the topography of the lesions of this poisoning, which is shared by other conditions such as Leber's disease or Leigh's syndrome, and the analogy with the presynaptic action of MPP+ in the parkinsonism due to MPTP, a possible implication of mitochondrial metabolism in the pathogenesis of this syndrome is discussed. The lack of knowledge of the real incidence of this complication in the survivors of methyl alcohol poisoning suggests the need to perform studies with a prolonged and systematic clinical follow up.