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KMID : 1013220060040020131
Jouranl of the Korean Society of Clinical Toxicology
2006 Volume.4 No. 2 p.131 ~ p.136
Reversible Metronidazole-induced Encephalopathy
Ji Ki-Hwan

Lee Jeong
Yun Chang-Ho
Ha Choong-Kun
Abstract
Metronidazole is an antimicrobial drug widely used against various types of infectious agents, including protozoa, amoeba, Helicobacter pylori, and anaerobes. Metronidazole may produce some adverse effects on hematologic, immunologic, neurologic and other systems. We report a case of reversible metronidazole-induced encephalopathy. The toxic dose of metronidazole and the onset of encephalopathy were variable. Two patients showed abnormally high signal intensity in the bilateral dentate nucleus of cerebellum, and characteristic abnormalities were detected by brain magnetic resonance imaging (MRI) and T2-weighted images, fluid-attenuated inversion recovery images and/or diffusion weighted imaging (DWI). Discontinuation of metronidazole resulted in the improvement of the neurologic symptoms over a period of two to three weeks. We followed up the brain MRI with DWI in one case following obvious clinical improvement, and the previously detected lesion had disappeared.
KEYWORD
Metronidazole, Encephalopathy, MRI
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