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Bilateral putaminal necrosis and bronopol toxicity.

Marina Trivisano1, Elena Carapelle2, Tommaso Martino2

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Methanol and bronopol can cause brain damage by forming formic acid. A case study shows bronopol in an antiseptic solution led to putaminal necrosis, but the patient surprisingly recovered.

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Area of Science:

  • Neuroscience
  • Toxicology
  • Internal Medicine

Background:

  • Methanol intoxication is a known cause of cerebral toxicity, including putaminal necrosis, due to formic acid formation.
  • The patient used a topical antiseptic containing bronopol for weight loss, a non-standard and dangerous practice.

Observation:

  • The patient presented with acute consciousness impairment and tetraparesis after ingesting bronopol-containing antiseptic solution.
  • Clinical presentation included severe respiratory and metabolic impairment, necessitating intensive care unit admission.

Findings:

  • Cerebral MRI revealed bilateral putaminal necrosis, a characteristic finding in toxic encephalopathies.
  • Bronopol, similar to methanol, can degrade into formaldehyde and subsequently formic acid, a neurotoxin targeting basal ganglia.

Implications:

  • This case highlights the potential neurotoxicity of bronopol and its metabolic products, particularly formic acid.
  • It underscores the critical need for caution with non-ingestible products and emphasizes the severe consequences of intentional misuse.