206. Moonshine-Induced Basal Ganglion Necrosis and Metabolic Acidosis

  1. Christopher P. Holstege MD1,2,3,
  2. Alexander B. Baer MD1,4,
  3. Jesse M. Pines MD, MBA, MSCE5,6 and
  4. William J. Brady MD7,8,9

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch206

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Holstege, C. P., Baer, A. B., Pines, J. M. and Brady, W. J. (eds) (2011) Moonshine-Induced Basal Ganglion Necrosis and Metabolic Acidosis, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch206

Editor Information

  1. 1

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 2

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 3

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 4

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 5

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 6

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 7

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 8

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 9

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

SEARCH

Keywords:

  • Case 96, moonshine-induced basal ganglion necrosis - and metabolic acidosis;
  • diagnosis - methanol poisoning;
  • patient, with nondetectable ethanol level - presenting methanol level, 168 mg/dL;
  • methanol, a toxic alcohol metabolized - to formaldehyde and formic acid, methanol inebriating;
  • high anion gap metabolic acidosis - with elevated osmolar gap, a toxic alcohol poisoning;
  • cells of retina, and optic nerve - susceptible to formic acid, visual loss and classic “snowstorm” visual deficit;
  • bilateral basal ganglion hypodensities - not specific for methanol poisoning;
  • basal ganglia (the putamen) - susceptible to damage, with necrosis or bleeding