Chronic severe methanol intoxication after repeated mask cleansing due to fear of COVID-19: A new risk of coronaphobia

Abstract

Background: Disproportionate fear of contracting COVID-19 (coronaphobia) may result in inappropriate use of preventive measures that could, in turn, result in severe harm to the patient. Objective: To describe a patient with subacute parkinsonism and cognitive dysfunction and magnetic resonance imaging (MRI) evidence of bilateral deep white matter and basal ganglia damage. Case presentation: A 56-year-old female presented with a 4-week history of insomnia, cognitive decline, and parkinsonism. Brain MRI revealed a bilateral lesion of both globus pallidus, deep white matter, and cerebellar hemispheres. Her son reported that, for the previous month, she had been cleaning her facial mask three times a day with a pure methanol solution as a disinfectant due to an intense fear of acquiring COVID-19. Previously, she had used 97% isopropyl alcohol and had inadvertently switched to methanol. After the exposure ended, she slowly improved but 4 months later she remains severely disabled. Conclusions: The repeated exposure to methanol vapor, the MRI findings, and the absence of other etiologies for her cognitive and parkinsonian features led to the diagnosis of chronic methanol intoxication with severe central nervous system damage. Misinformation is a likely contributory factor to such scenario. Efforts should be made by the scientific community to educate the general public on avoiding self-damaging behaviors as a result of coronaphobia.