Metronidazole-induced encephalopathy associated with treatment for liver abscesses

Metronidazole-induced encephalopathy (MIE) is a rare condition in Japan. We report the case of a patient with MIE who presented with abducens paralysis and ataxia without underlying risk factors. A history of metronidazole (MNZ) administration and rapid improvement after MNZ discontinuation are important in making this diagnosis, and characteristic findings of magnetic resonance imaging support the diagnosis. MIE is expected to become common in Japan as the use of MNZ increases because of expanded insurance coverage. Therefore, MIE needs to be recognized as a differential diagnosis of the central nervous symptoms in patients taking MNZ.