Metronidazole Induced Cerebellar Toxicity: A Case Report

Abstract

Metronidazole is a widely used antibiotic against bacterial and protozoan infections. Even though the therapeutic use of the drug is high, it is associated with some severe side effects like neurotoxicity such as optic neuropathy, peripheral neuropathy, encephalopathy and cerebellar toxicity. We present a case of a 55-years male presented with dysarthria, who had positive cerebellar sign and magnetic resonance imaging findings suggestive of metronidazole induced cerebellar toxicity following metronidazole therapy for two months in a case of liver abscess. And, the symptoms resolved after cessation of metronidazole.

Sensory-motor polyneuropathy due to the use of antiparasitic drugs: A case report

“…Among the 5-nitroimidazole group, only Metronidazole and Tinidazole [3] have been related to neurotoxicity, which may affect both the central and peripheral nervous system, although their mechanism is still not well understood. However, some theories have been proposed, such as that nerve damage is the result of free radicals produced during metronidazole metabolism or that metronidazole and its metabolites are capable of causing inhibition of protein synthesis, generating degeneration of nerve fibers [4] and, in rats, it was observed that the drug bound to RNA, leading to inhibition of protein synthesis and axonal damage [5,6].…”

“…However, when used in high doses and for a prolonged period, the risk of peripheral neuropathy increases; however, this effect is usually reversible when drug therapy is interrupted. There have also been reports of cerebellar dysfunction, vestibulotoxicity, cochlear toxicity, ataxic gait, and seizures [3][4][5].…”