Authors' reply: A rare presentation of methanol toxicity.

Dear Sir,

In our manuscript, the MRI of the brain had hemorrhagic conversion of infarct in bilateral parasagittal, parieto-occipital region. An acute infarct was seen in the right cerebellum. There were punctate infarcts in bilateral frontal regions.[1]

We would like to point out that the information given by Taheri et al.[2] is quite different from that given in our manuscript. Our patient had hemorrhagic conversion of infarct in bilateral parasagittal, parieto-occipital region, which is rare. Hemorrhage in the putamen has been described.[3] Also, infarct in the frontal lobe in case of methanol poisoning has been described by Ashan et al.[4] and Chen et al.,[5] as per the PUBMED search, which is a rare finding and definitely not reported for the first time.

Sefidbakht et al.[6] described bilateral necrosis of the basal ganglia along with other brain lesions which include edema, necrosis of subcortical white and gray matter, cerebellar cortical lesions, subarachnoid hemorrhage, bilateral intracerebral hemorrhage, bilateral tegmental necrosis, and diffuse cerebral edema. Again, there is not any mention of the areas and nature of lesions on the MRI found in our case report.

The lesions described in the case report were a mixture of the lesions that have been described in different case series and reports. To our knowledge, hemorrhagic conversion in case of infarcts in methanol poisoning has not been described. Lastly, frontal infarcts in methanol poisoning have been described in only two case reports as mentioned above. Moreover, the typical feature in our case was a mixture of lesions that have been described in different case series and reports.