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Updated: Jun 25, 2026

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
08:23

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

Published on: November 13, 2016

[Metronidazole-related polyneuritis, convulsive seizures, and cerebellar syndrome. Contribution of MRI]

J-P Ferroir1, C Corpechot, A Freudenreich

  • 1hôpital Tenon, Paris, France. jean-pierre.ferroir@tnn.aphp.fr

Revue Neurologique
|February 17, 2009
PubMed
Abstract

Insights

Long-term, high-dose metronidazole can cause rare neurological side effects, including peripheral neuropathy, cerebellar syndrome, and seizures. These symptoms and MRI findings resolved after discontinuing the medication.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Radiology

Background:

  • Neurological complications associated with metronidazole are uncommon.
  • Peripheral neuropathies are the most frequent adverse effects, particularly with prolonged high-dose use.
  • Cerebellar syndrome and seizures are less commonly reported.

Observation:

  • This case report details a patient experiencing three rare neurological complications from metronidazole.
  • Cerebellar syndrome was characterized by bilateral, symmetrical high signal intensity on T2-weighted MRI in the dentate nuclei, extending to the protuberance and subthalamic nucleus.
  • The patient presented with peripheral neuropathy, cerebellar syndrome, and seizures.

Findings:

  • The combined occurrence of peripheral neuropathy, cerebellar syndrome, and seizures as metronidazole side effects is exceptional.
  • Brain MRI revealed specific abnormalities in the cerebellum and subthalamic nucleus consistent with metronidazole toxicity.
  • Clinical symptoms and MRI findings showed significant improvement after metronidazole withdrawal.

Implications:

  • Metronidazole treatment, especially long-term or high-dose, necessitates careful monitoring for potential neurological adverse events.
  • Early recognition and discontinuation of metronidazole can lead to the reversal of neurological deficits and MRI abnormalities.
  • This case highlights the importance of considering metronidazole as a potential cause of complex neurological syndromes.

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