Reversible cerebellar neurotoxicity induced by metronidazole

Despite being in common use, metronidazole rarely causes cerebellar neurotoxicity. Damage can occur even at therapeutic doses, and although our patient received a higher dose than typically prescribed (125 g in total), the literature suggests that cerebellar neurotoxicity is unrelated to cumulative...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2018-08, Vol.190 (32), p.E961-E961
Main Authors: Lefkowitz, Ariel, MDCM, Shadowitz, Steven, MDCM MSc
Format: Article
Language:English
Subjects:
Care and treatment
Case studies
Complications and side effects
Diabetes
Diagnosis
Dosage and administration
Drug dosages
Emergency medical care
Internal Medicine
Liver cirrhosis
Magnetic resonance imaging
Medical diagnosis
Metronidazole
Neurotoxicity
Neurotoxicity syndromes
NMR
Nuclear magnetic resonance
Older people
Patients
Practice
Risk factors
Citations: Items that cite this one
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Description
Summary:Despite being in common use, metronidazole rarely causes cerebellar neurotoxicity. Damage can occur even at therapeutic doses, and although our patient received a higher dose than typically prescribed (125 g in total), the literature suggests that cerebellar neurotoxicity is unrelated to cumulative dose exposure or duration of treatment. Metronidazole toxicity can be diagnosed clinically or with an MRI demonstrating characteristic findings of symmetrically increased signal intensity for T2-, FLAIR- and diffusion-weighted imaging signal intensity in the supratentorial white matter and the deep cerebellar nuclei, in particular the dentate nuclei. Here, Lefkowitz and Shadowitz examine the case of 59-year-old man with cerebellar neurotoxicity.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.180231