To the Editor.
—On reading the article "Isopropyl Alcohol Intoxication" by Rich et al1 in the March issue of the Archives, I was struck by the fact that in all three of the cases presented there was nothing neurologically unique about these alcoholic subjects. In case 1, the sluggish pupils, prominent horizontal nystagmus, and appendicular and gait ataxia associated with peripheral neuropathy suggests Wernicke's encephalopathy.2 No mention is made of treatment with thiamine. In case 2, the patient had an alcohol-related seizure and subsequent delirium tremens. I am surprised that a computed tomographic scan of his brain was not performed, given his recent head trauma. In case 3, the coma is consistent with intoxication with isopropyl alcohol, which is well described.3The conclusions about the presentation of isopropyl alcohol intoxication presenting in two distinct patterns (stupor in a known alcoholic or encephalopathy in alcoholic subjects who hide
Wrenn K. Isopropyl Alcohol Intoxication. Arch Neurol. 1991;48(1):18. doi:10.1001/archneur.1991.00530130026007
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