Potent Potables: Examining Acute and Chronic CT and MR Imaging Patterns of Ethanol and Methanol Poisoning

Alcohol intoxication can present in many forms, which leads to diagnostic dilemmas. In this review, we examined both CT and MR imaging of acute and chronic imaging patterns of ethanol and methanol toxicity. In acute ethanol intoxication, we delineated imaging findings of Wernicke encephalopathy, Marchiafava-Bignami disease, osmotic demyelination syndrome, and acute hepatic encephalopathy, with attention to characteristic CT and MR imaging features of each entity. We similarly illustrated distinguishing imaging characteristics of acute methanol intoxication. We also delved into chronic ethanol poisoning by focusing on chronic acquired hepatic encephalopathy and seizurelike syndromes. Finally, we elucidated CT and MR imaging features of chronic methanol poisoning because it can manifest as multiple sclerosis mimics. In addition to detailing the distinct imaging features, we also correlated these entities with their respective physiologies, and, in doing so, we hope to achieve accurate diagnosis for the betterment of patient care.

Learning Objective: To understand the incidence and prevalence of alcohol toxicity and to elucidate the CT and MR features of acute and chronic forms of both ethanol and methanol toxicity while correlating with the physiology of each entity.