Abstract
Background: Metronidazole-induced encephalopathy (MIE) is caused by consumption of an excessive dose or prolonged use of metronidazole. Case Report: An 83-year-old female presented with left side ataxia and dysarthria. Initial brain magnetic resonance imaging (MRI) showed subtle high signal intensity in the splenium of corpus callosum. Three days later, she developed confused mental status. Follow-up brain MRI showed bilateral high signal intensities in the dentate nuclei of the cerebellum, splenium, insula, and subcortical white matter. She had infectious spondylitis and was taking metronidazole 1 g/day for 44 days. After discontinuation of metronidazole, her mental status and ataxia improved. Conclusion: Although initial brain MRI does not show typical lesions in a patient with clinically suspected MIE, follow-up brain MRI is recommended. Key Words: Metronidazole; Encephalopathy; Brain MRI
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