Year-end Sale % OFF 
Abstract
Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) findings strongly support the diagnosis, electroencephalography (EEG) features have been rarely reported and poorly described. We present a longitudinal EEG assessment in one patient with encephalopathy due to metronidazole toxicity who presented a peculiar EEG pattern presentation and evolution. During the acute phase of encephalopathy, the EEG showed a monomorphic, sharply contoured theta activity symmetrically represented over frontal regions with an anterior–posterior progression which evolved in parallel with clinical worsening. Together with a systematic review of the literature, we discuss whether this EEG activity may represent a distinct neurophysiological correlate of ‘cerebellar encephalopathy’.
Highlights
Metronidazole is an antimicrobial agent commonly used in the treatment of several protozoal and anaerobic infections
It is usually well tolerated, but it has occasionally been associated with the development of serious neurological adverse events, including peripheral neuropathy, cerebellar dysfunction, visual impairment, vestibulotoxicity, cochleotoxicity, ataxic gait, dysarthria, seizures and encephalopathy [1]
We identified nine cases of Metronidazole-induced encephalopathy (MIE) with an EEG description; EEG recordings were only available in three cases for critical revision
Summary
Metronidazole is an antimicrobial agent commonly used in the treatment of several protozoal and anaerobic infections. MIE is commonly reversible on discontinuation of metronidazole, but long-lasting sequelae and even fatal outcomes have been reported [3]. The exact dose required to provoke MIE is unknown since toxicity has been reported either at low or at high doses [4,5]. For these reasons, it is advisable to find diagnostic tools allowing a prompt diagnosis soon after symptoms onset. It is advisable to find diagnostic tools allowing a prompt diagnosis soon after symptoms onset
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
