Case Report

Metronidazole-induced encephalopathy

Vikash G. Lala, Bilal Bobat, Mark Haagensen, Prakash Kathan, Adam Mahomed
South African Journal of Radiology | Vol 25, No 1 | a2016 | DOI: https://doi.org/10.4102/sajr.v25i1.2016 | © 2021 Vikash G. Lala, Bilal Bobat, Mark Haagensen, Prakash Kathan, Adam Mahomed | This work is licensed under CC Attribution 4.0
Submitted: 10 October 2020 | Published: 18 March 2021

About the author(s)

Vikash G. Lala, Department of Gastroenterology, Faculty Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Bilal Bobat, Department of Gastroenterology, Faculty Internal Medicine, Wits Donald Gordan Medical Centre, Johannesburg, South Africa
Mark Haagensen, Department of Radiology, Faculty of Health Sciences, Wits Donald Gordan Medical Centre, Johannesburg, South Africa
Prakash Kathan, Department of Neurology, Faculty of Health Sciences, Wits Donald Gordan Medical Centre, Johannesburg, South Africa
Adam Mahomed, Department of Gastroenterology, Faculty Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg; Department of Gastroenterology, Faculty Internal Medicine, Wits Donald Gordan Medical Centre, Johannesburg, South Africa


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Abstract

Metronidazole is a widely used antibacterial and antiprotozoal agent for a number of conditions. Whilst its more common gastrointestinal side effects are well known, neurotoxicity remains under-recognised. Both central and peripheral neurological side effects have been described. This report describes a case of radiologically confirmed metronidazole-induced cerebellar ataxia in a cirrhotic patient with a review of the literature. Awareness of this side effect is essential for prompt recognition as early drug withdrawal leads to resolution in the majority of cases.


Keywords

metronidazole; metronidazole-induced cerebellar ataxia; metronidazole-induced neurotoxicity; metronidazole adverse events; metronidazole-induced encephalopathy; dentate nucleus lesions; splenium lesions; corpus callosum lesions

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