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Poisoning with methyl alcohol (methanol)

Methanol is the organic compound received by means of dry wood distillation or synthetically. A lethal dose in peroral intake is 30 ml, but grave poisonings accompanied by blindness may come as a result of the intake of 5-15 ml per os.

Poisoning with methanol is manifested with gastrointestinal disorders, CNS depression and cardiac failure. In poisoning, often, comes irreversible blindness on account of the optic nerve atrophy.

Signs of poisoning develop in a few hours, and, sometimes, on the 2-3 days. A narcotic effect of the poison is weakly expressed, and the phase of excitation is almost absent, and some time later a deep sleep comes after methanol intake.

In methanol poisoning the following forms of intoxication syndrome are distinguished:

Initial or first phase is accompanied by weakly expressed general cerebral manifestations of narcotic^effect. In favorable course these symptoms disappear a few days later.

Ophthalmic form is characterized, first of all, by disorders on the part of optic nerve and changes of fundus of the eye. Disorders of vision, up to its

complete loss, are revealed usually 2-3 days later after seeming well-being, but in separate cases blindness comes suddenly. It may be preceded by general toxic signs. In this form mildly expressed changes are possible on the part of blood. Cerebral disorders are reversible and usually disappear in the first days after poisoning, but in separate cases they may continue for a few weeks.

Form of generalized massive intoxication is notable for rapid development of vegetovascular syndrome in combination with cerebral symptoms — sweating, cyanosis, tachycardia, pains in the epigastric region, paresis of oculomotor muscles, mental confusion, change of reflexes, excitement and tonic convulsions. In some cases a deep coma develops with areflexia, dilatation of pupils with absence of light reaction, depression of cardiac activity and respiration, such patients die.

Treatment must be directed to the accelerated removal of poison from the organism, neutralization of its degradation products, normalization of vitally important functions, as well as a prevention of the loss of vision. In principle, it differs little from such applied in poisoning with ethyl alcohol. In substantial drop of vision or presence of blindness — lumbar punctures with extraction of 12-15 ml of cerebrospinal fluid and intralumbar administration of 5% vitamin B, — 1-2 ml, 0.5% novocaine solution 10 ml i/v daily for 10 days.

The antidote of methyl alcohol is ethyl alcohol that is recommended to infuse the patient just after poisoning intravenously drop-by-drop in the dose of 1 liter 5% solution in 5% glucose solution. Thereafter, every hour a patient is given 10-20% solution of ethyl alcohol to drink by 40-60 ml or it is infused i/v by 200 ml in 5% glucose solution seeing that an alcohol concentration in blood does not exceed 10 g/kg.

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