A 7 years girl, parent gave history of fever for which she was treated with Paracetamol following which the fever subsided. Later she developed seizures and altered sensorium. The urine examination revealed oxalate crystals on microscopy, Blood anion gap and osmolality were increased. The diagnosis is

**Core Concept**
Methanol poisoning is a critical condition that requires prompt recognition and treatment. It occurs when methanol is ingested, leading to the accumulation of toxic metabolites, which can cause severe neurological and metabolic disturbances.

**Why the Correct Answer is Right**
The patient's symptoms, including seizures, altered sensorium, and the presence of oxalate crystals in the urine, are indicative of methanol poisoning. Methanol is metabolized to formic acid, which is responsible for the toxic effects. The increased blood anion gap and osmolality are consistent with the accumulation of formic acid and its metabolites. The history of treatment with Paracetamol (acetaminophen) is also relevant, as it can be used as a antidote for methanol poisoning by replenishing glutathione stores.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided.
* **Option B:** This option is not provided.
* **Option C:** This option is not provided.
* **Option D:** This option is not provided.

**Clinical Pearl / High-Yield Fact**
Methanol poisoning is often underdiagnosed, and a high index of suspicion is required, especially in cases of unexplained seizures or altered sensorium. The presence of oxalate crystals in the urine is a specific finding that should prompt consideration of methanol poisoning.

**Correct Answer:** None of the above options are provided, but based on the information given, the correct diagnosis is Methanol poisoning.

✓ Correct Answer: B. Ethylene glycol