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Published on: October 2, 2018

Metronidazole induced encephalopathy in a patient with brain abscess

Yoochang Bahn1, Eunyoung Kim, Chongoon Park

  • 1Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.

Journal of Korean Neurosurgical Society
|November 18, 2010
PubMed

Insights

Metronidazole is a common brain abscess treatment, but severe neurotoxic complications like Metronidazole-induced encephalopathy (MIEP) can occur. This reversible condition requires neurosurgical awareness for accurate diagnosis and management.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Metronidazole is a first-line antibiotic for brain abscess treatment.
  • Neurotoxic complications of metronidazole, such as Metronidazole-induced encephalopathy (MIEP), are not widely recognized.
  • Differentiating MIEP from other neurological conditions can be challenging.

Observation:

  • A case of brain abscess treated with metronidazole developed severe, yet reversible, Metronidazole-induced encephalopathy.
  • The patient's MIEP presented with symptoms that mimicked other neurological disorders.
  • Typical neuroimaging findings of MIEP were observed, but differential diagnosis was complex.

Findings:

  • Metronidazole-induced encephalopathy (MIEP) is a rare but significant neurotoxicity associated with metronidazole therapy.
  • Severe MIEP can develop during the treatment of brain abscess, presenting diagnostic challenges.
  • Prompt recognition and discontinuation of metronidazole can lead to reversible neurological deficits.

Implications:

  • Neurosurgeons and clinicians must consider MIEP in patients treated with metronidazole, especially those with neurological symptoms.
  • Awareness of MIEP is crucial for accurate diagnosis, preventing misdiagnosis of conditions like cerebral infarction or demyelinating diseases.
  • Early identification and management of MIEP can prevent long-term neurological sequelae, highlighting the importance of vigilant monitoring during metronidazole therapy.
Keywords:
Brain abscessMetronidazoleToxic encephalopathy

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