Objective: To report the clinical course of secondary parkinsonism due to methanol toxicity with good levodopa responsiveness in the background of COVID-19 crisis.

Background: The economic crisis during the COVID-19 pandemic resulted in alcohol crisis in various regions, leading to instances of alcohol adulteration. We report a case of secondary parkinsonism, due to methanol toxicity.

Method: A case report

Results: We present a 26 year old woman from Bangladesh, with incidental ingestion of ethanol which was contaminated with methanol. During the same time period, there were many reports of hospitalizations and few deaths from various areas of Bangladesh due to alcohol adulteration. Our patient developed acute methanol toxicity with severe metabolic acidosis, acute renal injury, dyselectrolytemia, and required mechanical ventilation with subsequent gradual recovery. Few weeks later, she became slow in all her activities, had recurrent unprovoked falls, slurred speech and depression with anxiety. These complains were progressive. On examination she had symmetric parkinsonism, with slow saccades, hypomimia, hypophonia, mild oro-pharyngeal dysphagia, prominent axial rigidity, and impaired postural control. Her unified Parkinson’s disease rating scale (UPDRS) motor score was 49 and cognitive examination was normal. She developed bilateral optic atrophy with progressive worsening of vision. Brain MRI scan was suggestive of bilateral putaminal necrosis. She was started on levodopa-carbidopa, dopamine agonists and was injected with botulinum toxin. She underwent neuro-rehabilitation. Her UPDRS motor score improved to 19 in ON state.

Conclusion: Hence we report a case of levodopa responsive secondary parkinsonism due to methanol toxicity in background of alcohol crisis due to economic breakdown during COVID 19 pandemic.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-case-of-levodopa-responsive-parkinsonism-due-to-methanol-toxicity-an-impact-of-covid-19-crisis/