Metronidazole-induced encephalopathy and polyneuropathy

Area of Science:

• Neurology
• Pharmacology
• Toxicology

Background:

• Metronidazole is an effective antibiotic, but prolonged or high-dose therapy can lead to serious side effects.
• Metronidazole-induced neurotoxicity, including peripheral neuropathy and encephalopathy, can be debilitating.

Purpose of the Study:

• To report a case of severe neurological sequelae following metronidazole treatment.
• To highlight the importance of recognizing metronidazole-induced neurotoxicity.

Main Methods:

• A case study of a middle-aged man treated with high-dose metronidazole for a liver abscess.
• Neurological assessment included nerve conduction studies (NCS) and magnetic resonance imaging (MRI).

Main Results:

• The patient developed dysarthria, ataxic gait, and sensory loss consistent with peripheral neuropathy.
• NCS confirmed axonal neuropathy, and MRI showed T2/FLAIR hyperintensities indicative of toxic encephalopathy.
• Symptoms significantly improved after discontinuing metronidazole.

Conclusions:

• High-dose or prolonged metronidazole therapy can cause severe neurological damage, including peripheral neuropathy and encephalopathy.
• Clinicians should maintain vigilance for neurotoxicity in patients receiving long-term or high-dose metronidazole.
• Early recognition and cessation of metronidazole are crucial for symptom recovery.