Metronidazole toxicity presenting with cerebellar ataxia

Neki, N.S.; Joshi, N. J.; Rana, Deepak Singh; Shergill, Gagandeep Singh; Walia, Sargun Singh; Singh, Gagandeep; Multani, Gurminder Singh; Joshi, Gayatri

doi:10.22192/ijcrms.2017.03.05.003

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…Metronidazole-induced neurotoxicity is likely an underrecognized and under-reported entity, with its true incidence remaining unknown. Despite this, a number of case reports documenting both metronidazole-induced peripheral neuropathies 13 and encephalopathy 14,15,16,17,18 with metronidazole-induced encephalopathy. 19 In this study, encephalopathy was reported across a wide range of age groups; although, most case studies were documented in patients above the age of 40.…”

Section: Discussionmentioning

confidence: 99%

Metronidazole-induced encephalopathy

Lala

Bobat

Haagensen

et al. 2021

South African Journal of Radiology

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Metronidazole is a widely used antibacterial and antiprotozoal agent for a number of conditions. Whilst its more common gastrointestinal side effects are well known, neurotoxicity remains under-recognised. Both central and peripheral neurological side effects have been described. This report describes a case of radiologically confirmed metronidazole-induced cerebellar ataxia in a cirrhotic patient with a review of the literature. Awareness of this side effect is essential for prompt recognition as early drug withdrawal leads to resolution in the majority of cases.

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Section: Discussionmentioning

confidence: 99%

Metronidazole-induced encephalopathy

Lala

Bobat

Haagensen

et al. 2021

South African Journal of Radiology

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“…4 Use of metronidazole in excessive doses can give rise to neurological problems such as cerebellar ataxia, seizures, peripheral neuropathies, and encephalopathy. 1 Cerebellar toxicity is a very unusual manifestation of metronidazole therapy, the dosage usually ranges from 25 to 1080 gm and therapeutic duration ranging from 5 to 730 days. 2 The imaging findings of metronidazole toxicity were first described by Ahmed et al, as symmetric abnormal signal within supratentorial white matter, including the corpus callosum, and within the cerebellum, including the cerebellar deep gray matter nuclei.…”

Section: Figure 3: Flair Hyperintensity In Dentate Nucleus Of Cerebelmentioning

confidence: 99%

“…Dizziness, vertigo, and very rarely encephalopathy, convulsions and ataxia are neurotoxic effects that need drug discontinuation. 1 Neurological features usually manifest when the drug is used in a dose exceeding 2 gm/day for prolonged periods. 1 Cerebellar ataxia due to Metronidazole, the dosage usually ranges from 25 to 1080 gm and therapeutic duration ranging from 5 to 730 days, with classic findings on magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

“…1 Neurological features usually manifest when the drug is used in a dose exceeding 2 gm/day for prolonged periods. 1 Cerebellar ataxia due to Metronidazole, the dosage usually ranges from 25 to 1080 gm and therapeutic duration ranging from 5 to 730 days, with classic findings on magnetic resonance imaging (MRI). 2,3 Most CNS adverse effects usually resolve over a period of 2-8 weeks.…”

Section: Introductionmentioning

confidence: 99%

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Importance of magnetic resonance imaging brain in metronidazole-induced cerebellar ataxia- a case report

Kumar

Priyadarshini

2021

Int J Res Med Sci

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Metronidazole is an antibiotic and an antiprotozoal drug, is cost effective treatment of choice in amoebic liver abscess. Cerebellar toxicity is quite rare and serious side effect of metronidazole, which is reversible. The importance of MRI brain in this condition is the typical finding of abnormal T2 as well as FLAIR hyperintensities in dentate nuclei and splenium of corpus callosum. We present a case of liver abscess on prolong metronidazole treatment presented with acute onset cerebellar ataxia.

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“…1 Neurological features usually manifest when the drug is used in a dose exceeding 2 g/day for prolonged periods. 2 In case of Cerebellar ataxia due to Metronidazole, the dosage usually ranges from 25g to 1080g and therapeutic duration ranging from 5 to 730 days. 3 Here we present an interesting case of cerebellar ataxia with a far lower dose of Metronidazole that is 6 gms.…”

Section: Introductionmentioning

confidence: 99%

Metronidazole Induced Cerebellar Ataxia: A Rare Case Report

K¹,

Rai²

2019

IJCMR

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Introduction:Metronidazole is an antibiotic and an antiprotozoal drug very commonly used in our day to day practice. It is either used alone or in combination with other drugs to treat Pelvic inflammatory disease, Endocarditis and Bacterial Vaginosis. It is generally well tolerated and common side effects include nausea, vomiting, abdominal cramps, metallic taste. Case report:We are presenting a rare case of Metronidazole induced cerebellar ataxia in a patient who received the drug for a relatively shorter duration. Conclusion:The neurological features usually occur when the drug dose exceeds 2g/day for a prolonged period. Peripheral neuropathy, dizziness, encephalopathy, seizures, optic neuropathy can be seen. Cerebellar ataxia is a rare and serious side effect of this drug.

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Metronidazole toxicity presenting with cerebellar ataxia

Cited by 4 publications

References 10 publications

Metronidazole-induced encephalopathy

Metronidazole-induced encephalopathy

Importance of magnetic resonance imaging brain in metronidazole-induced cerebellar ataxia- a case report

Metronidazole Induced Cerebellar Ataxia: A Rare Case Report

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