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Metronidazole induced encephalopathy with peripheral polyneuropathy in patient with spinal cord injury
Gi Hoon Hwang1, Young-Joo Sim1, Ho Joong Jeong1
1Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea.
Abstract:
Metronidazole may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy. We experienced neurological side effects of metronidazole. The 32-year-old female patient with spinal cord injury was diagnosed as encephalophathy and peripheral polyneuropathy resulting from complication of metronidazole. It was difficult to diagnose at first glance using clinical findings because of paraplegia due to spinal cord injury. But through magnetic resonance imaging with diffusion weighted imaging and electrophysiologic study, the patient showed to have characteristic abnormalities that of a person suffering from metronidazole-induced encephalopathy and peripheral polyneuropathy. Whether the symptoms were caused by a peripheral nerve lesion or MIE, the patient's paraplegia prevented to appear other symptoms, such as ataxic gait and seizure, from manifesting. In such case as this, an active differentiated diagnosis is crucial.
Insights
Metronidazole can cause neurological issues like encephalopathy and neuropathy. A spinal cord injury patient developed these complications, highlighting the need for careful diagnosis despite confounding symptoms.
Area of Science:
- Neurology
- Pharmacology
- Medical Imaging
Background:
- Metronidazole is associated with potential neurological side effects.
- Diagnosing these side effects can be challenging, especially in patients with pre-existing neurological conditions.
Purpose of the Study:
- To report a case of metronidazole-induced encephalopathy and peripheral polyneuropathy.
- To emphasize the diagnostic challenges and methods in a patient with spinal cord injury.
Main Methods:
- Case report of a 32-year-old female patient.
- Utilized magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI).
- Performed electrophysiologic studies.
Main Results:
- The patient presented with encephalopathy and peripheral polyneuropathy.
- MRI and electrophysiologic studies revealed characteristic abnormalities consistent with metronidazole-induced neurological complications.
- The patient's paraplegia masked typical symptoms like ataxia and seizures.
Conclusions:
- Metronidazole-induced encephalopathy and peripheral polyneuropathy can occur.
- Advanced imaging and electrophysiologic studies are crucial for diagnosis in complex cases.
- Active differential diagnosis is essential when symptoms are obscured by other conditions.
