A Rare Case of Metronidazole Induced Encephalopathy Presenting as an Isolated Seizure Episode


Authors : Urvi Zala; Abhi Shah; Rushi Patel; Vedant Shah; Joy Chaudhari; Viraj Panchal; Himanshu Pandya

Volume/Issue : Volume 8 - 2023, Issue 8 - August

Google Scholar : https://bit.ly/3TmGbDi

Scribd : http://tinyurl.com/2csbnczh

DOI : https://doi.org/10.5281/zenodo.8315004

Abstract : - Metronidazole is a commonly used drug for the treatment of anaerobic and protozoal infections. Various common side effects of metronidazole include nausea, anorexia, vomiting, diarrhoea, and abdominal cramping. However, the central nervous system can rarely be affected by metronidazole toxicity. Patients mainly present with cerebellar dysfunction or altered mental status. Seizures are a rare but possible presenting feature, particularly in those receiving high doses of the drug. We present a case of metronidazole induced encephalopathy (MIE) in a 76-year-old man who experienced a seizure episode following the use of metronidazole for a post-surgical infection. The MRI findings of brain showed a focal area of signal abnormality within the splenium of the corpus callosum, seen as an area of FLAIR/T2 hyperintensity with mild restricted diffusion, which was consistent with the diagnosis of metronidazole toxicity.

Keywords : Flagyl, Metronidazole Side Effects, Splenium of the Corpus Callosum, New-Onset Seizure, Metronidazole Induced Encephalopathy.

- Metronidazole is a commonly used drug for the treatment of anaerobic and protozoal infections. Various common side effects of metronidazole include nausea, anorexia, vomiting, diarrhoea, and abdominal cramping. However, the central nervous system can rarely be affected by metronidazole toxicity. Patients mainly present with cerebellar dysfunction or altered mental status. Seizures are a rare but possible presenting feature, particularly in those receiving high doses of the drug. We present a case of metronidazole induced encephalopathy (MIE) in a 76-year-old man who experienced a seizure episode following the use of metronidazole for a post-surgical infection. The MRI findings of brain showed a focal area of signal abnormality within the splenium of the corpus callosum, seen as an area of FLAIR/T2 hyperintensity with mild restricted diffusion, which was consistent with the diagnosis of metronidazole toxicity.

Keywords : Flagyl, Metronidazole Side Effects, Splenium of the Corpus Callosum, New-Onset Seizure, Metronidazole Induced Encephalopathy.

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