Neuroimaging and Clinical Course of Methanol-Induced Encephalopathy: Insights from a Recent Mass-Poisoning Event

Abstract

Methanol poisoning remains a significant public-health concern, especially in regions where restrictive alcohol policies foster illicit and unregulated alcohol production. The Kuwait methanol outbreak of August 2025 resulted in numerous fatalities and neurological injuries. This case report describes a survivor who initially received dialysis in Kuwait but returned to India several days later with persistent cognitive dysfunction. At presentation, he exhibited slowed mentation but had remarkably good visual recovery. MRI revealed classical features of methanol-induced neurotoxicity, including bilateral putaminal hyperintensities and deep white matter involvement. The patient was managed at the Department of Neurology, Fortis Hospital, Jalandhar. Although fomepizole was not administered during the initial Kuwait-based treatment, supportive care and neuro-rehabilitation resulted in gradual cognitive improvement. He was eventually discharged in stable condition with only minor residual neural complications. This case highlights the characteristic imaging findings of methanol toxicity, demonstrates the potential for partial neurological recovery even after delayed presentation, and emphasizes the need for improved regulatory and clinical preparedness to mitigate the consequences of toxic alcohol outbreaks.