Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Atypical Metronidazole-Induced Encephalopathy in Anaerobic Brain Abscess

  • Jang, Han Jin (Department of Neurosurgery, National Medical Center) ;
  • Sim, Sook Young (Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Jong Yun (Department of Neurology, National Medical Center) ;
  • Bang, Ji Hwan (Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine)
  • Received : 2011.12.19
  • Accepted : 2012.08.29
  • Published : 2012.09.28
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Abstract

Metronidazole-induced encephalopathy is a very rare complication of the long standing use of metronidazole. The encephalopathy is bilateral and symmetric in nature. We report on the magnetic resonance imaging (MRI) and clinical course of metronidazole-induced encephalopathy in a 60-year-old female with a persistent anaerobic brain abscess after draining of the abscess. After 3 months of metronidazole administration, the patient complained of dysarthria, tingling sense of all extremities, and left hemiparesis. MRI revealed symmetric hyperintensity lesions in medulla, pons, dentate nuclei of cerebellum, and splenium of corpus callosum, all of which represent typical findings of metronidazole-induced encephalopathy. In addition, asymmetric lesions in midbrain, thalamus, putamen and cerebral subcortical white matter were noted. The patient recovered after discontinuation of metronidazole and the remaining abscess was successfully treated with meropenem and levofloxacine.

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References

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