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Metronidazole Induced Encephalopathy

Nisarg Thakkar1, Bhaarat1, Ramesh Chand1

  • 1Resident.

The Journal of the Association of Physicians of India
|November 3, 2016
PubMed

Insights

Metronidazole can cause neurological toxicity, including seizures and altered sensorium. This case highlights reversible brain changes in the dentate nuclei and corpus callosum associated with metronidazole-induced encephalopathy.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Metronidazole is a widely used antimicrobial for anaerobic bacterial and protozoal infections.
  • Neurological toxicity is a recognized, albeit concerning, adverse effect of metronidazole.
  • Increasing case reports underscore the importance of recognizing metronidazole-induced neurotoxicity.

Observation:

  • A 32-year-old male with chronic alcoholism and liver abscesses presented with seizures, peripheral neuropathy (burning feet), and altered mental status.
  • The patient had a history of 6 weeks of metronidazole treatment.
  • Clinical presentation suggested a potential neurological adverse event related to medication.

Findings:

  • Magnetic Resonance Imaging (MRI) of the brain revealed characteristic abnormalities.
  • Specific findings included involvement of the dentate nuclei and the splenium of the corpus callosum.
  • These radiological findings are typical of metronidazole-induced encephalopathy (MIE).

Implications:

  • This case highlights the potential for metronidazole to cause significant, yet reversible, neurological toxicity.
  • Early recognition and diagnosis of metronidazole-induced encephalopathy are crucial for prompt management.
  • Awareness among clinicians is vital, especially in patients with risk factors like chronic alcoholism.

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