title: Clinical and imaging perspective and unanswered questions in a case of metronidazole induced encephalopathy.
abstract: We discuss the clinical and imaging perspective in a case of a 78-year-old male who developed slurring of speech and ataxia acute in onset for the last 3 days. During his hospital stay, he developed multiple episodes of focal seizures without secondary generalization involving the angle of mouth on the right side. The patient had ataxia and positive cerebellar signs. In the past, the patient was treated for amoebic liver abscess and had undergone percutaneous aspiration of abscess. The patient was prescribed oral metronidazole and was discharged. This time, the patient underwent magnetic resonance imaging examination, which revealed lesion highly suggestive of metronidazole-induced encephalopathy. The offending drug was discontinued immediately after which the patient improved clinically. A follow-up scan was performed after 12 days and showed complete resolution of lesions.
authors: Department of Medicine, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India.
authors: Asif
authors: A
authors: Iqbal
authors: Kamlakar
authors: K
authors: Tripathi
authors: Madhukar
authors: M
authors: Rai
authors: Amit Nandan Dhar
authors: AN
authors: Dwivedi
keywords: Diffusion-weighted imaging; fluid-attenuated inversion-recovery; magnetic resonance imaging; metronidazole-induced encephalopathy