Magnetic resonance spectroscopy after methanol poisoning

A 27‐year‐old Japanese man ingested methanol. He presented with reduced vision and lost consciousness after 2 days. He became comatose and developed metabolic acidosis, but improved and was discharged after 18 days. A brain magnetic resonance imaging–fluid attenuation inversion recovery sequence showed lesions in the putamen, caudate nucleus and subcortical white matter of both cerebral hemispheres. Magnetic resonance spectroscopy showed a low N‐acetylaspartate level, and high choline and lactic acid levels in the right putamen lesion, indicating that recovery coincided with symptom improvement. These magnetic resonance spectroscopy features might reflect the neuronal mitochondrial dysfunction and anaerobic glycolysis caused by the effect of formic acid, a metabolite of methanol.