Metronidazole-induced Neurotoxicity: A Case Report

JOURNAL TITLE: Bengal Physician Journal

Author
1. Mohamed Ibrahim
2. Imad Hamad
3. Devdutt Nayak
4. Anandi Damodaran
5. Saima Majid
6. Faisal Khan
ISSN
DOI
10.5005/jp-journals-10070-7077
Volume
9
Issue
1
Publishing Year
2022
Pages
3
Author Affiliations
    1. Department of Neurology, Kuwait Hospital, Sharjah, United Arab Emirates
    1. Department of Neurology, Kuwait Hospital, Sharjah, United Arab Emirates
    1. Department of Internal Medicine, Kuwaiti Hospital, Sharjah, United Arab Emirates
    1. Department of Internal Medicine, Kuwaiti Hospital, Sharjah, United Arab Emirates
    1. Department of Internal Medicine, Kuwaiti Hospital, Sharjah, United Arab Emirates
    1. Department of Internal Medicine, Kuwaiti Hospital, Sharjah, United Arab Emirates
  • Article keywords
    Cerebellar signs, Dentate nucleus hyperintensity, Metronidaole toxicity, Peripheral neuropathy

    Abstract

    Metronidazole (MTZ) is an antibiotic from nitroimidazole group, commonly used for various medical and surgical indications especially anaerobic bacterial infection. Though usually safe, it can result in serious toxicity with prolonged use. It can affect both central and peripheral nervous system. Neurotoxicity presents as features of encephalopathy, cerebellar ataxia, dysarthria, and symmetrical sensory-motor polyneuropathy. Here, we are presenting our patient with liver abscess who received MTZ for 6 weeks and developed neurological side effects with cerebellar ataxia and dysarthria accompanied by MRI features—hyperintense signals in dentate nucleus consistent with toxicity and also features of symmetrical sensory-motor polyneuropathy. Cerebellar symptoms reversed with stopping the medication—however, his peripheral neuropathy had a static course with minimal recovery.

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