MR imaging and diffusion-weighted imaging changes in metronidazole (Flagyl)-induced cerebellar toxicity.
We describe a case demonstrating reversible MR imaging findings, including diffusion-weighted imaging changes in association with metronidazole (Flagyl) toxicity. The diagnosis of metronidazole toxicity was made clinically and supported by the MR imaging findings. Quantitative apparent diffusion coefficient (ADC) maps demonstrated edema with associated increased ADC values within the dentate nuclei of the cerebellum on initial imaging. Follow-up imaging performed 8 weeks after cessation of metronidazole therapy demonstrated resolution of imaging findings, including diffusion changes.
D018784:Abdominal Abscess / Q000188:drug therapy*; D000008:Abdominal Neoplasms / Q000150:complications / Q000556:secondary*; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000633:toxicity*; D002276:Carcinoid Tumor / Q000150:complications / Q000556:secondary*; D002524:Cerebellar Ataxia / Q000139:chemically induced* / Q000175:diagnosis; D002529:Cerebellar Nuclei / Q000187:drug effects / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000633:toxicity*; D004401:Dysarthria / Q000139:chemically induced* / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000633:toxicity*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis*; D015242:Ofloxacin / Q000008:administration & dosage; D012075:Remission, Spontaneous
D000890:Anti-Infective Agents; D008795:Metronidazole; D000658:Amoxicillin; D015242:Ofloxacin