Bilateral putaminal necrosis and bronopol toxicity

Marina Trivisano, Elena Carapelle, Tommaso Martino, Luigi Maria Specchio

Research output: Contribution to journalArticle

Abstract

Among alcohols, methanol intoxication is the most frequently associated with cerebral toxicity, causing retinal damage and putaminal necrosis. This consequence is believed to be due to the transformation of methanol into formic acid. We describe the case of a patient who presented with acute impairment of consciousness and tetraparesis after she had been drinking several bottles of a topical antiseptic solution (Lysoform Medical) containing 2-bromo-2-nitro-1,3-propandiol (bronopol) among excipients, in order to lose weight during previous months. Moreover, she had been on a strict slimming diet. Soon after admission, a severe respiratory and metabolic impairment became rapidly evident, requiring an intensive care unit admission. Cerebral MRI showed the presence of bilateral putaminal necrosis. She recovered in 10 days, surprisingly, without any evident clinical neurological signs. Methanol, also bronopol, when diluted in aqueous solution, at warm temperature and/or higher pH, may release formaldehyde, which is converted into formic acid, a basal ganglia toxic compound.

Original languageEnglish
JournalBMJ Case Reports
Volume2015
DOIs
Publication statusPublished - Feb 19 2015

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formic acid
Methanol
Necrosis
Alcoholic Intoxication
Local Anti-Infective Agents
Excipients
Poisons
Basal Ganglia
Consciousness
Formaldehyde
Drinking
Intensive Care Units
Diet
Weights and Measures
Temperature

ASJC Scopus subject areas

  • Medicine(all)

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Bilateral putaminal necrosis and bronopol toxicity. / Trivisano, Marina; Carapelle, Elena; Martino, Tommaso; Specchio, Luigi Maria.

In: BMJ Case Reports, Vol. 2015, 19.02.2015.

Research output: Contribution to journalArticle

Trivisano, Marina ; Carapelle, Elena ; Martino, Tommaso ; Specchio, Luigi Maria. / Bilateral putaminal necrosis and bronopol toxicity. In: BMJ Case Reports. 2015 ; Vol. 2015.
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