Open AccessLong-term Implication of Metronidazole Induced Reversible Cerebellar Toxicity and Peripheral Neuropathy- A Case Report
Author(s) -
Parmendra Sirohi,
Hardeva Ram Nehara,
Avadusidda Arakeri,
Atma Ram Chhimpa,
Sunil Ih
Publication year - 2021
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/ijars/2021/48155.15200
Subject(s) - metronidazole , fluid attenuated inversion recovery , medicine , neurotoxicity , cerebellum , discontinuation , magnetic resonance imaging , hyperintensity , peripheral neuropathy , encephalopathy , toxicity , anesthesia , surgery , radiology , antibiotics , endocrinology , diabetes mellitus , biology , microbiology and biotechnology
Metronidazole Induced Encephalopathy (MIE) is rare and serious central nervous system toxicity. A 40-year-old male, on long-term self treatment with metronidazole (cumulative dose: 102 gm) presented with dysarthria, nystagmus, unsteadiness, and numbness in both legs. A Magnetic Resonance Imaging (MRI) scan of the brain revealed a symmetric hyperintensity in both the dentate nuclei of cerebellum on both T2 weighted and Fluid-Attenuated Inversion-Recovery (FLAIR) imaging. Discontinuation of metronidazole resulted in resolution of the imaging findings and clinical improvement occurred within one month. Metronidazole-induced neurotoxicity should be considered in patient who present with cerebellar symptoms and characteristic lesion on MRI in close temporal relation with metronidazole intake and drug should be discontinued to prevent permanent neurological deficit.