Case report: MRI of the brain in metronidazole toxicity

Abstract

Metronidazole is a commonly used antimicrobial drug. When used excessively, it can cause encephalopathy. We report the MRI findings in one such case. A 43-year-old male patient was treated with metronidazole for 2 months, for an amebic liver abscess and presented with neurological signs and symptoms. MRI of the brain showed findings consistent with metronidazole toxicity.

MR features of metronidazole-induced encephalopathy

“…It poses a diagnostic challenge clinically because of its rarity. MR is an important adjunct in diagnosing this condition because of characteristic features on it 1. In the previous case reports, typical brain lesions have been described in the cerebellar dentate nucleus, midbrain, dorsal pons, medulla and splenium of the corpus callosum.…”

Metronidazole CNS toxicity

“…2a, b) without corresponding clear decreased intensity on ADC. These distinctive MRI findings have been described in metronidazole toxicity [1].Upon stopping metronidazole, the patient's dysarthria resolved within a day. Repeat brain MRI 4 months later showed resolution with minimal residual findings.…”

Metronidazole Induced Encephalopathy: Imaging of an Unusual Side Effect

“…The neuroimaging is important in the diagnosis of metronidazole induced encephalopathy because of the characteristic involvement of dentate nucleus (characteristic), midbrain, corpus collasum, medulla, inferior colliculus, basal ganglia and thalamus [5] . The lesions present in the form of symmetrical hypo intense lesions on T1 weighted images and hyperintensities on T2W and FLAIR [6] . since metronidazole induced encephalopathy and its neuroimaging is rare we here report acase of metronidazole induced encephalopathy and discuss its neuroimaging findings.…”