Poisoning is included in the differential diagnosis of coma. Even in absence of coma, intoxication is often present after ingestion of toxic alcohols, or there may be parallel ingestion of ethanol. The only clue may be the presence of an early osmolar gap or, later in presentation, an anion gap in the case of ethylene glycol or methanol.
Once the diagnosis is made, there is some specific treatment based on enzymatic blockade in order to reduce toxic metabolic byproducts. As always, good supportive care is of primary importance.