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Poisoning usually follows ingestion of contaminated alcohol beverages or
'methylated spirits'. Intoxication in industrial settings follows
absorption across the skin or lung. It is metabolised by alcohol
dehydrogenase to formaldehyde, which is itself rapidly oxidised to the
principle toxin, formic acid.
Signifcant ingestion causes nausea, vomiting and abdo pain. Its effects on
the CNS resemble those of ethanol although in low doses it does not have a
Visual symptoms present with falling visual acuity, photophobia and the
sensation of 'being in a snow storm'.
Up to 2/3rds of patients have a raised amylase (haemorrhagic pancreatitis
has been reported at post mortem)
Seizures are seen in severe intoxication. CT scanning usually shows
cerebral oedema or even necrosis in the basal ganglia (a Parkinsonian-like
state is sometimes seen with recovery).
Patients with visual symptoms may develop irreversible visual impairment
even with aggressive intervention.
Ingestion of only 10ml can cause blindness and 30ml can be fatal.
© 2003 Clinical Pharmacology Unit, Department of Medicine, University of