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

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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.
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Keywords: AHE = acute hepatic encephalopathy; CHE = chronic hepatic encephalopathy; MBD = Marchiafava-Bignami disease; MI = methanol intoxication; ODS = osmotic demyelination syndrome; PLEDs = periodic lateralized epileptiform discharge; WE = Wernicke encephalopathy

Document Type: Research Article

Publication date: August 1, 2018

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  • Neurographics is the peer-reviewed, bimonthly educational journal of the American Society of Neuroradiology. The journal comprises articles selected from material presented at the ASNR Annual Meeting. Neurographics also publishes other high-quality submissions that are primarily educational and have a high emphasis on a pictorial approach. Neurographics offers CME credit for reading review articles and completing quiz-based self-assessment activities. CME credit for review articles may be claimed up to 3 years after an article's publication date. Visit to view all available CME courses.
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