HLA and thyrotoxic periodic paralysis.

A CAT-scan performed six days after the first symptoms disclosed areas of decreased attenuation with a remarkable specific localisation to the putamens. It is tempting to suggest that the transient difficulties in articulation and swallowing, as well as the pyramidal tract symptoms, were due to the influence of oedema on corticobulbar and corticospinal fibres adjacent to the putamen. The CAT-scan finding (figure) is of special interest in relation to the neuropathological findings in fatal cases of methanol intoxication.1-4 Orthner3 found symmetrical areas of necrosis in the putamens in 41 of 42 deaths from methanol. Thus the present case suggests that methanol intoxication should be seriously considered when a CATscan shows bilateral low-attenuating areas in the putamens.