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Unveiling the Neurotoxicity of Metronidazole: A Clinical Conundrum
Gollapudi Hithesh1, Swathy Moorthy2, Lakshmi M3
1General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Abstract:
Metronidazole, a commonly used antiprotozoal agent, has been linked to neurotoxicity in a few individuals. We present the case of a 61-year-old gentleman diagnosed with a liver abscess, who received a total dose of 64 g of metronidazole over a four-week duration. He subsequently developed slurred speech, numbness, and tingling sensation in both feet. His neuroimaging revealed T2 hyperintensities in the bilateral dentate nuclei and withdrawal of the drug led to symptomatic improvement in the patient. Metronidazole is known to produce neurological manifestations with involvement of peripheral nerves and cerebellum commonly. In the present case, the cumulative dose impact of metronidazole on the dentate nucleus was evident.
Insights
High-dose metronidazole can cause neurotoxicity, affecting speech and sensation. This case highlights cumulative dose effects on the dentate nucleus, with symptoms improving after drug withdrawal.
Area of Science:
- Neurology
- Pharmacology
Background:
- Metronidazole is an antiprotozoal agent frequently used in clinical practice.
- Neurotoxicity is a known, albeit rare, adverse effect of metronidazole.
- Neurological manifestations commonly involve peripheral nerves and the cerebellum.
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