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Metronidazole Induced Cerebellar Toxicity: A Case Report
Shova Sapkota1, Aliska Niroula1, Rina Prajapati2
1Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
JNMA; Journal of the Nepal Medical Association
|February 24, 2022
Summary
Metronidazole can cause severe neurotoxicity, including cerebellar issues. This case highlights reversible cerebellar toxicity from this common antibiotic, emphasizing the need for awareness.
Area of Science:
- Neurology
- Pharmacology
- Infectious Diseases
Background:
- Metronidazole is a crucial antibiotic for bacterial and protozoan infections.
- High therapeutic use is linked to severe neurotoxic side effects.
- Reported neurotoxicity includes optic neuropathy, peripheral neuropathy, encephalopathy, and cerebellar toxicity.
Observation:
- A 55-year-old male presented with dysarthria and positive cerebellar signs.
- Clinical presentation was suggestive of metronidazole-induced cerebellar toxicity.
- The patient had undergone two months of metronidazole therapy for a liver abscess.
Findings:
- Magnetic resonance imaging (MRI) confirmed findings consistent with cerebellar toxicity.
- Cerebellar signs and symptoms were directly attributed to metronidazole use.
- Cessation of metronidazole led to the complete resolution of symptoms.
Implications:
- This case underscores the potential for metronidazole-induced cerebellar toxicity.
- Highlights the importance of recognizing and managing neurotoxic side effects of metronidazole.
- Suggests prompt drug withdrawal can lead to symptom recovery in metronidazole-induced neurotoxicity.
