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Metronidazole-Induced Recurrent Paresthesia: A Case Report.
1Department of Physical Medicine and Rehabilitation, Kyung-Hee Medical Center, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, Korea.
Neurology India
|March 1, 2021
Summary
Long-term metronidazole use can cause peripheral neuropathy. This case study shows a patient who developed nerve damage after years of metronidazole treatment, with symptoms recurring upon re-exposure.
Area of Science:
- Neuroscience
- Pharmacology
Background:
- Metronidazole is a commonly prescribed antibiotic and antiprotozoal medication.
- Prolonged use of metronidazole has been anecdotally linked to neurotoxicity.
- Peripheral neuropathy is a potential adverse effect of various medications.
Observation:
- A 54-year-old woman with a history of chronic metronidazole use for vaginitis presented with bilateral foot pain and numbness.
- Nerve conduction studies (NCS) indicated axonal peripheral polyneuropathy with sensory fiber involvement.
- Paresthesia recurred immediately upon restarting metronidazole therapy.
Findings:
- The patient's symptoms and NCS findings strongly suggest metronidazole-induced peripheral neuropathy.
- Electromyography (EMG) studies and a 6-month follow-up confirmed the diagnosis.
- The neuropathy appears to be primarily sensory, affecting the sural and superficial peroneal nerves.
Implications:
- This case highlights the importance of considering metronidazole as a potential cause of peripheral neuropathy, especially with long-term use.
- Clinicians should be vigilant for neurological symptoms in patients on chronic metronidazole therapy.
- Further research into the mechanisms and risk factors for metronidazole-induced neurotoxicity is warranted.
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