Teaching NeuroImage: Nitromethane-Induced Acute Reversible Encephalopathy. (28th September 2021)

• Record Type: Journal Article
• Authors: Palumbo, Giovanni; Besana, Michele; Ananiadou, Sofia; Giordano, Carolina; Maccabelli, Gloria; Riccio, Mario; Campana, Chiara; Giossi, Alessia; Piovan, Enrico; Lonati, Davide; Pinelli, Lorenzo
• Is Part Of: Neurology. Volume 97:Number 13(2021)
• Page Start: e1361
• Page End: e1362
• Publication Date: 2021-09-28
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000012178
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : A 60-year-old man presented to the emergency department reporting that he accidently swallowed a sip (about 20 mL) of nitromethane he used as fuel for his racing bikes. Over the following 2 days, he became stuporous, experienced tonic-clonic seizures, and ultimately fell into a coma. Brain MRI showed multifocal gray matter T2/fluid-attenuated inversion recovery hyperintensities consistent with previously published findings of acute nitromethane encephalopathy 1 (Figure 1, A and B). After 1 week, the follow-up MRI showed massive vasogenic brain edema (Figure 1, C and D). Nonetheless, the patient's condition was improving with supportive therapy only. One month after his admission, he was back to baseline and he was discharged; 6 months later, brain MRI was normal (Figure 2).