title: Clinical and Neuroradiological Spectrum of Metronidazole Induced Encephalopathy: Our Experience and the Review of Literature.
abstract: Metronidazole is an antimicrobial agent mainly used in the treatment of several protozoal and anaerobic infections, additionally, is often used in hepatic encephalopathy and Crohn disease. Apart from peripheral neuropathy, metronidazole can also cause symptoms of central nervous system dysfunction like ataxic gait, dysarthria, seizures, and encephalopathy which may result from both short term and chronic use of this drug and is collectively termed as "metronidazole induced encephalopathy"(MIE). Neuroimaging forms the backbone in clinching the diagnosis of this uncommon entity, especially in cases where there is high index of suspicion of intoxication. Although typical sites of involvement include cerebellum, brain stem and corpus callosum, however, lesions of other sites have also been reported. Once diagnosed, resolution of findings on Magnetic Resonance Imaging (MRI) of the Brain along with clinical improvement remains the mainstay of monitoring. Here we review the key clinical features and MRI findings of MIE as reported in medical literature. We also analyze implication of use of this drug in special situations like hepatic encephalopathy and brain abscess and discuss our experience regarding this entity.
authors: Resident, Department of Neurology, Bangur Institute of Neurosciences, IPGMER , Kolkata, India .
authors: Ujjawal
authors: U
authors: Roy
authors: Senior Resident, Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital , New Delhi, India .
authors: Ajay
authors: A
authors: Panwar
authors: Associate Professor, Department of Neurology, Bangur institute of Neurosciences, IPGMER , Kolkata, India .
authors: Alak
authors: A
authors: Pandit
authors: Resident, Department of Neurology, Bangur Institute of Neurosciences, IPGMER , Kolkata, India .
authors: Susanta Kumar
authors: SK
authors: Das
authors: Resident, Department of Neurology, Bangur Institute of Neurosciences, IPGMER, Kolkata, India.
authors: Bhushan
authors: B
authors: Joshi
keywords: Cerebellum; Corpus callosum; Magnetic resonance imaging; Nitroimidazoles; Toxicity