Rapid coma with bilateral basal ganglia involvement

1

Acute severe encephalopathy with bilateral basal ganglia abnormalities can indicate various differential diagnoses, including hypoxic-ischemic injury and mitochondrial disorders.
2

Brain MRI may reveal bilateral and symmetrical basal ganglia involvement, suggestive of disulfiram-induced neurotoxicity.
3

Disulfiram neurotoxicity is linked to oxidative stress affecting dopaminergic structures like the substantia nigra.
4

Most cases of disulfiram neurotoxicity are reversible, but severe presentations can lead to poor neurological outcomes.
5

Disulfiram toxicity should be considered in unexplained encephalopathy with symmetric deep gray nuclei involvement, even in long-term users.