Open AccessClinical and imaging perspective and unanswered questions in a case of metronidazole induced encephalopathy
Author(s) -
Asif Iqbal,
Kamlakar Tripathi,
Madhukar Rai,
Amit Nandan Dhar Dwivedi
Publication year - 2013
Publication title -
annals of indian academy of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.427
H-Index - 31
eISSN - 1998-3549
pISSN - 0972-2327
DOI - 10.4103/0972-2327.120472
Subject(s) - metronidazole , medicine , ataxia , encephalopathy , magnetic resonance imaging , lesion , abscess , liver abscess , hepatic encephalopathy , brain abscess , surgery , radiology , antibiotics , cirrhosis , psychiatry , microbiology and biotechnology , biology
We discuss the clinical and imaging perspective in a case of a 78-year-old male who developed slurring of speech and ataxia acute in onset for the last 3 days. During his hospital stay, he developed multiple episodes of focal seizures without secondary generalization involving the angle of mouth on the right side. The patient had ataxia and positive cerebellar signs. In the past, the patient was treated for amoebic liver abscess and had undergone percutaneous aspiration of abscess. The patient was prescribed oral metronidazole and was discharged. This time, the patient underwent magnetic resonance imaging examination, which revealed lesion highly suggestive of metronidazole-induced encephalopathy. The offending drug was discontinued immediately after which the patient improved clinically. A follow-up scan was performed after 12 days and showed complete resolution of lesions.