Toxic Alcohols (Ethylene Glycol, Methanol, and Isopropanol)

Poisoning by ethylene glycol and methanol requires early diagnosis and treatment to prevent accumulation of their toxic acid metabolites and subsequent development of profound metabolic acidosis and end-organ complications.

Causes

Symptoms

• Early (1 to 12 hours): anorexia, nausea, vomiting, abdominal pain, headache, vertigo, weakness, lethargy, coma
• Late (6 to 36 hours): progressive visual disturbances (e.g., blurred vision, diplopia, scotomata, "snowfields," tunnel vision, blindness), shortness of breath, confusion, lethargy, seizures, coma, hematemesis, flank pain

Signs

• Early: CNS inebriation (e.g., slurred speech, nystagmus, lethargy, coma, ataxia)
• Late: progressive visual field and acuity deficits, optic disc hyperemia, papilledema, mydriasis nonreactive to light, confusion, agitation, delirium, coma, myoclonus, tetany, seizures, tachypnea, hyperpnea, ketotic breath, sinus tachycardia, hypertension or hypotension.

Treatment