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Metronidazole-induced encephalopathy

Vikash G Lala1, Bilal Bobat2, Mark Haagensen3

  • 1Department of Gastroenterology, Faculty Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

SA Journal of Radiology
|April 7, 2021
PubMed

Insights

Metronidazole can cause under-recognized neurotoxicity, specifically cerebellar ataxia. Early recognition and drug withdrawal are crucial for recovery from this metronidazole side effect.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Metronidazole is a common antibacterial and antiprotozoal medication.
  • Gastrointestinal side effects are well-documented, but neurotoxicity is less recognized.
  • Neurological adverse effects can be central or peripheral.

Observation:

  • This report details a case of metronidazole-induced cerebellar ataxia.
  • The patient had cirrhosis and confirmed radiological findings.
  • A literature review was conducted alongside the case study.

Findings:

  • Metronidazole-induced cerebellar ataxia is a rare but serious neurotoxic effect.
  • Prompt recognition and discontinuation of metronidazole are key.
  • Most patients experience resolution of symptoms after drug withdrawal.

Implications:

  • Clinicians should be aware of metronidazole neurotoxicity, particularly cerebellar ataxia.
  • Early diagnosis and intervention improve patient outcomes.
  • This highlights the importance of monitoring for neurological side effects of metronidazole.
Keywords:
corpus callosum lesionsdentate nucleus lesionsmetronidazolemetronidazole adverse eventsmetronidazole-induced cerebellar ataxiametronidazole-induced encephalopathymetronidazole-induced neurotoxicitysplenium lesions

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