Convulsions associated with high cumulative doses of metronidazole

Metronidazole in high cumulative doses has been associated with convulsions. A case is presented in which this relationship is clear. In all reported cases of metronidazole-associated seizures, the cumulative dose of metronidazole has been high (greater than 40 g). The cumulative dose rather than the serum level is important in the pathogenesis of this complication.