Methanol poisoning: a clinical and pathological study

We report 2 survivors of severe methanol poisoning who developed, apart from blindness, a Parkinson-like extrapyramidal syndrome characterized by reduced initiative, poor voice volume, masked facies, mild tremor, rigidity, and bradykinesia. Both patients were mildly demented and 1 had hyperreflexia and bilateral Babinski responses. Computed tomographic scans in both patients demonstrated bilateral symmetrical infarction of the frontocentral white matter and putamen. Electromyography in 1 patient showed extensive denervation, mainly involving the legs, but normal motor conduction velocities. L-Dopa administered to the more severely affected patient had no effect on the parkinsonian features. Autopsy revealed cystic resorption of the putamen and the frontocentral subcortical white matter in additon to widespread neuronal damage throughout the cerebrum, cerebellum, brainstem, and spinal cord.