The person may not be aware of drinking methanol if:
(1) it was in an improperly labeled container
(2) it was added accidentally
(3) it was given to the person by someone else
Findings in a patient who has ingested methanol:
(1) The patient may appear mildly intoxicated.
(2) The level of intoxication is persistent.
(3) The patient has the delayed onset of symptoms (8 to 36 hours after ingestion) followed by deterioration.
Early symptoms may include:
(1) blurred vision
(2) seeing flashing lights
(3) headache
(4) vomiting or diarrhea
(5) rapid breathing (tachypnea)
(6) drowsiness
(7) fixed and dilated pupils
(8) hypotension
(9) bradycardia
Differential diagnosis:
(1) hangover
(2) drug co-ingestion
If the patient only showed mild intoxication, then delayed symptoms may be much greater than expected for a relatively small amount of ethanol.
If the person had ingested methylated ethanol, then the co-ingested ethanol may be therapeutic for the methanol initially.
A positive test for ethanol does not exclude methanol poisoning if methylated spirits was ingested.
