Reversible Metronidazole-induced Encephalopathy

메트로니다졸에 의해 유발된 가역적 뇌증 2례

  • Ji, Ki-Hwan (Department of Neurology, College of Medicine, Inha University) ;
  • Lee, Jeong (Department of Neurology, College of Medicine, Inha University) ;
  • Yun, Chang-Ho (Department of Neurology, College of Medicine, Inha University) ;
  • Ha, Choong-Kun (Department of Neurology, College of Medicine, Inha University)
  • 지기환 (인하대학교 의과대학 신경과학교실) ;
  • 이정 (인하대학교 의과대학 신경과학교실) ;
  • 윤창호 (인하대학교 의과대학 신경과학교실) ;
  • 하충건 (인하대학교 의과대학 신경과학교실)
  • Published : 2006.12.31

Abstract

Metronidazole is an antimicrobial drug widely used against various types of infectious agents, including protozoa, amoeba, Helicobacter pylori, and anaerobes. Metronidazole may produce some adverse effects on hematologic, immunologic, neurologic and other systems. We report a case of reversible metronidazole-induced encephalopathy. The toxic dose of metronidazole and the onset of encephalopathy were variable. Two patients showed abnormally high signal intensity in the bilateral dentate nucleus of cerebellum, and characteristic abnormalities were detected by brain magnetic resonance imaging (MRI) and T2-weighted images, fluid-attenuated inversion recovery images and/or diffusion weighted imaging (DWI). Discontinuation of metronidazole resulted in the improvement of the neurologic symptoms over a period of two to three weeks. We followed up the brain MRI with DWI in one case following obvious clinical improvement, and the previously detected lesion had disappeared.

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